Pediatric Supracondylar Process Fracture: Radiographic Distinction, Misdiagnosis, and Conservative Management

Area of Science:

• Orthopedics
• Pediatric Orthopedics
• Radiology

Background:

• The supracondylar process is a remnant of the embryonic supracondylar foramen, often appearing as a distal humerus bone spur.
• Distinguishing supracondylar process fractures from osteochondromas is crucial for appropriate patient management.

Observation:

• An 11-year-old presented with a history of an asymptomatic mass, initially misdiagnosed as osteochondroma at age five.
• Radiographic analysis revealed a supracondylar process fracture after a fall, characterized by a tapered bony prominence with a lucent base.

Findings:

• The patient was successfully treated with a long-arm cast, resulting in uneventful healing and complete symptom resolution.
• Radiographic features, including a tapered prominence and lucency at the base, were key in identifying the supracondylar process fracture.

Implications:

• Accurate radiographic interpretation is vital to prevent misdiagnosis of supracondylar process fractures as osteochondromas.
• Conservative management, such as casting, is a viable and effective treatment option for supracondylar process fractures when neurovascular compromise is absent.