Straight Arm Traction for Paediatric Supracondylar Fractures
Presented in National Undergraduate Paediatric Conference 2014, March 8-9th, 2014, Glasgow, UK
Antonia Isaacson, Nicholas Heinz*,Oliver Bevan, Jonathan Hurst, David Emery
University Hospital of North Staffordshire, Stoke-On-Trent, United Kingdom
Abstract
Address for Correspondence: Nicholas Heinz, University Hospital of North Staffordshire, Stoke-On-Trent, United Kingdom. Email: v1e52@students.keele.ac.uk

Supracondylar fractures make up 16 % of all pediatric fractures and 66% of all pediatric elbow injuries. The peak incidence is at 7 years old and often results from a fall onto an outstretched hand, producing a typical extension type (95%) supracondylar fracture.

Aim: In this study we review the management protocol and outcomes of non-operative supracondylar fracture management in pediatric patients under the age of 11, treated with in line traction at the University Hospital of North Staffordshire (UHNS).

Methods: A retrospective review of patient’s notes and corresponding radiographs were performed in all patients treated with in-line skin traction at UHNS, who had an extension type fractures (Gartland 1, 2 or 3) with no vascular compromise between 2010 and the current time.

Results: Thirty-one patients were treated under traction with opiate analgesia as required. The mean time spent in traction was 16.9 days (median: 17 days, Mode: 13 days). It was found that 6 and 7 year olds spent less time on traction than younger children. Patients with Gartland 1 injuries spent 9.75 days on traction, Gartland 2 injuries spent 16.38 days and Gartland 3 injuries spent 19.2 days.

Conclusion: Closed, displaced supracondylar fractures excluding those presenting with vascular compromise can be treated successfully on straight-arm traction. Thus negating the need for surgery or an anaesthetic. On average children under the age of 10 require 16.9 days on traction, after which patients are able to mobilize and have a good range of elbow movement from extension to greater than 90 degrees flexion.
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