Manipulation of pediatric supracondylar fractures of humerus in prone position under general anesthesia.

Abstract

Displaced pediatric supracondylar fractures are usually treated with manipulation and fixation with Kirschner wires. The procedure is commonly performed with the patient in supine position. Reducing and stabilizing the fracture with the patient in supine position are associated with various risks and technical difficulties. We describe a technique of manipulative reduction and fixation of pediatric supracondylar fractures by positioning the patient prone. We have used this technique in 455 patients and prefer it to the commonly described method of fracture reduction and stabilization with the patient supine. Positioning the patient prone simplifies the reduction and provides adequate exposure to insert Kirschner wires safely from both medial and lateral aspects. Positioning the C-arm is easily achieved, and good radiographs are obtained without disturbing the reduced fracture. Level III.