Sequential Opposite-pattern Supracondylar Fractures in the Same Elbow of a Child

Supracondylar humerus fractures in children are most commonly of the extension type, whereas flexion-type injuries are rare. Sequential occurrence of extension- and flexion-type supracondylar fractures in the same elbow is extremely uncommon. We report a child who sustained a Gartland type II extension-type supracondylar fracture at 5 years of age, managed conservatively with above-elbow casting. He recovered fully and resumed normal activities. Ten months later, at age 6 years, he sustained a new fall on the same limb and presented with a Gartland type III flexion-type supracondylar fracture. Closed reduction and crossed K-wire fixation were performed, wires were removed at three weeks, and mobilization was initiated. At 1-year follow-up, he demonstrated a full range of motion and no deformity. This rare sequential pattern may represent either two independent trauma events or a possible refracture in the setting of structurally unverified healing after conservative treatment. The case highlights refracture-related considerations reported in pediatric fracture literature and underscores the importance of radiographic follow-up and counseling regarding return to activity in children treated non-operatively.