American Board of Surgical Assistants (ABSA) Orthopedic Practice Test

What is the most serious complication that can arise from a supracondylar fracture of the humerus?

1. Comminuted fracture

2. Volkmann's contracture

3. Radial nerve injury

4. Rotator cuff tear

The correct answer is: Volkmann's contracture

Volkmann's contracture is considered the most serious complication that can arise from a supracondylar fracture of the humerus due to the potential for significant and lasting damage to the muscles and nerves in the forearm. This condition develops as a result of ischemia (lack of blood flow) that occurs when there is increased pressure in the forearm compartment, often due to swelling or bleeding following the fracture. In the case of a supracondylar fracture, particularly in children, the injury can lead to swelling that compresses the muscles and nerves in the area, specifically affecting the brachial artery and the median nerve. If not recognized and treated promptly, this can result in muscular necrosis, leading to the characteristic claw-like deformity known as Volkmann's contracture. The compromised blood supply can result in irreparable damage, affecting the patient's ability to use their hand effectively. The consequences of Volkmann's contracture can be profound, including permanent functional loss of the hand, which highlights why it is deemed the most serious complication in comparison to other potential issues such as nerve injuries or simple fractures.