In the adult, supracondylar fractures are uncommon and a case series of 3 with humeral shaft extension is interesting. More commonly in the adult, we would expect to see intercondylar fractures. The commonest adult elbow fracture is the radial head fracture. (There is a good article available at  http://emedicine.medscape.com/article/824654-overview#a0199  by Nishijima and Kulkani)

It is also interesing to note that 1 patient had a radial nerve palsy. Supracondylar fractures put the median nerve at risk and the humeral shaft fracture puts the radial nerve at risk. It would have been interesting to know if the radial nerve was visualised at operation and protected during fixation - it is mentioned that no patient had a neurovascular deficit on admission. This could make a discussion point on its own.

The final point I wish to raise is the methods section. Did these 3 patients present after the same accident? If so, 3 patients with rare injuries presenting at the same time makes this report even more noteworthy for it unusuality. Perhaps this could be clarified and each case history described individually

I have worked for several years in orthopaedica and trauma surgery