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            [0] => Flexion-Type Supracondylar Humeral Fracture associated with Epitrochlear Fracture in Children: A Case Report and Review of the Literature
        )

    [etablissement] => Array
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            [0] => Orthopedics and traumatology department. Hospital of Mohamed Taher Maamouri. Nabeul
        )

    [nom] => Array
        (
            [0] => Jlidi
        )

    [prenom] => Array
        (
            [0] => Mohamed
        )

    [email] => Array
        (
            [0] => medjlidi@hotmail.fr
        )

    [telephone] => Array
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            [0] => 29030521
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    [auteurs] => Array
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            [0] => 
 
Nom prénom / Name Surname: Belkadhi Imen
Email: imen123belkadhi@gmail.com
Hôpital / Hospital: Hospital of Mohamed Taher Maamouri

 
Nom prénom / Name Surname: Bouaicha Walid
Email: walid_bouaicha@yahoo.fr
Hôpital / Hospital: Hospital of Mohamed Taher Maamouri

 
Nom prénom / Name Surname: Lamouchi Mouldi
Email: hmouldi92@gmail.com
Hôpital / Hospital: Hospital of Mohamed Taher Maamouri

 
Nom prénom / Name Surname: Mars Houssem
Email: houssemmars@gmail.com
Hôpital / Hospital: Hospital of Mohamed Taher Maamouri

 
Nom prénom / Name Surname: Zoghlami Elyes
Email: zelyes46@gmail.com
Hôpital / Hospital: Hospital of Mohamed Taher Maamouri

 
Nom prénom / Name Surname: Daas Selim
Email: selimdaas@yahoo.fr
Hôpital / Hospital: Hospital of Mohamed Taher Maamouri

        )

    [mots_cles] => Array
        (
            [0] => Flexion-Type Supracondylar Humeral Fracture;
Epitrochlear Fracture;
Children;
Surgery;

        )

    [event-id] => Array
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            [0] => 3663
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            [0] => 1
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    [user_email] => Array
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            [0] => medjlidi@hotmail.fr
        )

    [specialite] => Array
        (
            [0] => Chirurgie orthopédique et traumatologique
        )

    [pays] => Array
        (
            [0] => Tunisie
        )

    [texte_abs] => Array
        (
            [0] => Introduction: 
 Supracondylar humeral fracture is a common fracture in the pediatric population. 
A flexion type is very uncommon with an incidence of 2 to 3% of all supracondylar fractures. 
The combination of a flexion-type supracondylar humeral fracture with an epitrochlear fracture is extremely rare and represents a real challenge for an orthopaedic surgeon.
We report a case of the rare associated fracture in a 13-year-old patient treated surgically with a good final result.
Methods:
We present the case of A 13-year-old male patient, with no history, was a victim of a domestic fall landing on his outstretched left upper limb.
Clinical examination showed swelling and diffuse tenderness over the left elbow. The skin was intact and there were no associated neuro-vascular complications. Antero-posterior and lateral X ray views of the left elbow showed a supracondylar fracture of the left elbow with anterior displacement associated with a fracture of the epitrochlea.
The child was taken to the operating room six hours after the injury. Under general anesthesia, using a medial approach, an open reduction was attempted. After dissecting and protecting the ulnar nerve, the supracondylar fracture was initially reduced and stabilized by medial and lateral cross pinning. Thereafter, the epitrochlear fracture was reduced and fixed with two pins. Peroperative fluoroscopic views confirmed the good reduction. The left upper limb was immobilized in a long arm plaster splint.
The splint and the pins were removed at 6 weeks after the surgery.
Results:
 At the last follow-up, the elbow had regained active flexion at 120◦, with a flexion contracture of 10◦ and full prono-supination. The fracture was healed.
Conclusion: 
Although no guidelines for the management of these  fractures exist, this case report enhance the existing literature that flexion-type supracondylar fractures with epitrochlear fracture  are associated with higher rates of open reduction.
Open reduction with medial approach is needed not only to achieve an anatomic reduction of the supra condylar and epitrochlear fracture at the same time but to make sure also that the ulnar nerve is not entrapped between the proximal and distal fragment.
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