Abstract：Objective This study explored the clinical and imaging features of the supracondylar process of the humerus in children, as well as the diagnosis and treatment methods, to improve clinicians' understanding of this disease.Methods A retrospective study was performed on four patients with the supracondylar process in our center from January 2016 to June 2019. Relevant pieces of literature on Pubmed, CNKI, Wanfang, and Weipu were reviewed. The key words were “supracondylar process” and “pediatric/children.” Nine cases reported in Chinese and four cases reported in English were found. Data on the clinical and imaging features, treatment, and prognosis were obtained and analyzed.Results Four cases of humeral supracondylar process were recorded in our center, including three boys and one girl (average age=4.5 years). One 4-year-old boy underwent surgical resection. During operation, the process, ligament, and shaft of the humerus formed a ring or canal through which the median nerve and the brachial artery (or a branch of it) were transmitted. We successfully resected the process and the ligament with its entire periosteum. Postoperatively, supracondylar was confirmed by histological examination. No recurrence was noted at follow-up throughout the subsequent 3.5 years. The remaining three patients were followed-up for 2.5 years on average, and no enlargement or compression symptoms were observed. According to the literature review, 13 patients (6 boys and 3 girls; age=2-11 years) were included. Among the 13 patients, 6 underwent surgery, all of whom manifested with pain and 4 showed symptoms of median nerve compression; the other 7 patients were treated conservatively. The prognosis of all these patients was good. The supracondylar process should be distinguished from osteochondroma. Literature review showed that the spur was oriented distally toward the elbow joint and without discontinuity in the cortex of the humerus. X-ray imaging revealed an intact underlying humeral cortex, in contrast to osteochondroma in which the tumor cortex was continuous with the humeral cortex, pointing away from the joint.Conclusions Supracondylar process is an anatomical variation and needs to be distinguished from osteochondroma. Surgery is warranted when growth is rapid and compression symptoms emerge, during which the process and the ligament with its entire periosteum should be resected entirely.
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2020, Vol. 25 
