Therefore, closed reduction and immobilization is competing with routine Kirschner wire fixation. Level III-retrospective comparative study.Ĭopyright © 2022 Wolters Kluwer Health, Inc. Abstract Purpose: The therapy of distal radial fractures in children is expected to be as non-invasive as possible but also needs to deliver the definite care for gaining optimal reduction and stabilizing the fracture. Increasing fracture extension on injury radiographs can help predict failure of nonoperative management following closed reduction. Patient age, prereduction and postreduction Baumann angle, and the postreduction splint flexion angle did not differ significantly between groups.Ĭlosed reduction under conscious sedation in the emergency department is a viable treatment option for Gartland type IIa supracondylar humerus fractures. It has the advantages of a small surgical wound, short. The mean anterior humeral line index on the postreduction radiograph was 1.2 in the nonoperative group and 0.38 in the operative group (P=0.0002). This technique was developed to be the standard treatment of unstable paediatric forearm fractures. The mean anterior humeral line index on the injury radiograph was 0.34 in the nonoperative group and 0.13 in the operative group (P=0.104). The postreduction degree of fracture extension was 3.0☓.4 degrees in the nonoperative group and 10.0☗.2 degrees in the operative group (P<0.0001). The degree of fracture extension on the injury radiograph was 13.2☘.4 degrees in the nonoperative group compared with 19.8☗.5 degrees in the operative group (P=0.008). Following the closed reduction in the emergency department, 38 (70%) patients were successfully managed nonoperatively with casting, and 16 (30%) patients required operative intervention. The success of closed reduction was defined as a reduction that was maintained without the need for surgical intervention.Ī total of 54 patients (54 elbows) were included in this study. Prereduction and postreduction radiographs were reviewed to determine the degree of fracture extension, anterior humeral line index, Baumann angle, and splint flexion angle. This was a retrospective cohort study of pediatric patients who underwent closed reduction of Gartland type IIa supracondylar humerus fractures with the use of conscious sedation in the emergency department. Our goal was to identify variables associated with fractures that were successfully managed nonoperatively. In this article, we describe our retrospective clinical review of 187 patients with nasal trauma, 96 of whom underwent closed reduction for nasal fracture. We report the results of a series of patients with type IIa fractures who underwent closed reduction and immobilization using conscious sedation in the emergency department. For additional information visit Linking to and Using Content from MedlinePlus.The optimal treatment of Gartland type IIa supracondylar humerus fractures remains controversial. Any duplication or distribution of the information contained herein is strictly prohibited without authorization. Links to other sites are provided for information only - they do not constitute endorsements of those other sites. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. It is also used when you do not need hardware such as pins, screws, or plates to hold the pieces of bone in place. Closed reduction is used when your bone is broken in one place and the bone pieces have not gone through the skin. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Closed reduction is a procedure to put the pieces of a broken bone back into the right place without surgery. It works best when it is done as soon as possible after the bone breaks. The broken bone is put back in place, which allows it to grow back together in better alignment. This site complies with the HONcode standard for trustworthy health information: verify here. Closed reduction is a procedure to set (reduce) a broken bone without cutting the skin open. Learn more about A.D.A.M.'s editorial policy editorial process and privacy policy. is among the first to achieve this important distinction for online health information and services. follows rigorous standards of quality and accountability. is accredited by URAC, for Health Content Provider (URAC's accreditation program is an independent audit to verify that A.D.A.M.
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