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Supracondylar Humerus Fracture Clinical Pathway – Emergency Department

Emergency Department Clinical Pathway for Supracondylar Humerus Fracture

 
 
 
 

Triage

  • Assess neurovascular status, pain
  • Ibuprofen, ice
  • RN Standing Order, 2 view elbow
 
 

History and Physical
Assess for other injuries
Skin integrity, neurovascular exam

 
 

Supracondylar Fracture Classification
Image review by Radiology and Orthopedics to determine fracture classification

 
 
 
 
 
 
Type I Fracture
Type II Fracture
Type III Fracture
  • Long arm cast by ED tech
  • Orthopedics if no ED tech available
  • Ortho APP/resident reviews eligibility for discharge, discusses with Ortho attending
  • Cast or splint by Orthopedics
  • If casting, no more than 70° flexion
  • Splint in 30°–50° flexion by Orthopedics
  • Monitor pulses, neurovascular exam
 
 
 
 
 
 
Admit for surgical intervention
 
 
 
 
Follow-up in 1 wk
  • Child to return within 72 hrs for surgery (likely following day add-on)
  • Child NPO except clear liquids after midnight until contacted following morning (by noon) with time of surgery
  • KOPH Fracture Discharge Scheduling
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