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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 1, 82-87.
doi: 10.1302/0301-620X.87B1.14584  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Elevated, straight-arm traction for supracondylar fractures of the humerus in children

A. Gadgil, FRCS, Specialist Registrar Orthopaedics

Department of Orthopaedics, University Hospital of Wales, Heath Park, Cardiff, UK.

C. Hayhurst, MRCS, SHO, Orthopaedics; N. Maffulli, FRCS(Orth), Professor of Orthopaedics; and J. S. M. Dwyer, FRCS(Orth), Consultant Paediatric Orthopaedics

University Hospital of North Staffordshire and Keele University, Stoke on Trent ST4 7QB, UK.

Correspondence should be sent to Mr J. S. M. Dwyer.

Between January 1995 and December 2000, 112 children with a closed displaced supracondylar fracture of the humerus without vascular deficit, were managed by elevated, straight-arm traction for a mean of 22 days. The final outcome was assessed using clinical (flexion-extension arc, carrying angle and residual rotational deformity) and radiographic (metaphyseal-diaphyseal angle and humerocapitellar angle) criteria. Excellent results were achieved in 71 (63%) patients, 33 (29%) had good results, 5 (4.4%) fair, and 3 (2.6%) poor. All patients with fair or poor outcomes were older than ten years of age.

Elevated, straight-arm traction is safe and effective in children younger than ten years. It can be effectively used in an environment that can provide ordinary paediatric medical care and general orthopaedic expertise. The outcomes compare with supracondylar fractures treated surgically in specialist centres.




eLetters:

Read all eLetters

Letter from Mr Chirputkar
Kedar V Chirputkar
J Bone Joint Surg Br Online, 18 Jan 2005 [Full text]
Letter from Mr Kakarala
Gopikrishna Kakarala, et al.
J Bone Joint Surg Br Online, 10 Mar 2005 [Full text]
Elevated, straight-arm traction for supracondylar fractures of the humerus in children
Athanasios V. Papavasiliou, et al.
J Bone Joint Surg Br Online, 12 May 2005 [Full text]
Response to the letter from Dr Papavasiliou and Mr Isaac
Jonathan S.M. Dwyer, et al.
J Bone Joint Surg Br Online, 5 Sep 2005 [Full text]
Response to the letter from Mr Kakarala and Mr Lahoti
Jonathan S.M. Dwyer, et al.
J Bone Joint Surg Br Online, 6 Sep 2005 [Full text]
Response to Mr Chirputkar
Jonathan S.M. Dwyer, et al.
J Bone Joint Surg Br Online, 5 Sep 2005 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General