Management of displaced extension-type supracondylar fractures of the

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humerus in children [published erratum appears in J Bone Joint Surg [Am] 1988 Aug;70(7):1114] Pirone-AM; Graham-HK; Krajbich-JI Division of Orthopaedic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada. J-Bone-Joint-Surg-Am. 1988 Jun; 70(5): 641-50 The cases of 230 patients who had a displaced extension-type supracondylar fracture of the humerus were reviewed retrospectively. The results of treatment by four different methods were assessed clinically and compared. The mean length of follow-up was 4.6 years (range, one to nine years). The highest percentages of excellent results were achieved by percutaneous Kirschner-wire fixation (78 per cent), skeletal traction (67 per cent), and open reduction with internal fixation (67 per cent). Closed reduction and application of a cast was associated with a significantly lower percentage of early and late complications, including Volkmann ischemic contracture and cubitus varus. It is recommended that treatment with a cast be reserved for undisplaced fractures only. Percutaneous Kirschner-wire fixation is advocated as the method of choice for the majority of displaced fractures.