title: Gradual reduction of supracondylar fracture of the humerus in children reporting late with a swollen elbow.
abstract: OBJECTIVE
  To study the outcome of gradual reduction by skin traction of supracondylar fracture of the humerus in children with swollen elbow, who seek treatment two days or longer after the injury.
  
  
  METHODS
  Fifteen children aged between 4 and 11 years (average 7 years 11 months), who had initially consulted a traditional practitioner, reported between 2 and 21 days (average 7.5) after the injury were treated by skin traction with the elbow kept straight and the forearm in position of comfort.
  
  
  RESULTS
  The average duration of stay in hospital was 14 days. All fractures healed; there was no incidence of myositis ossificans or neurovascular deficit. All patients had functional range of movements at the elbow within 6 months. Five patients developed cubitus varus deformity greater than 5 degrees, they were classified as poor result. Four out of these 5 patients had sought treatment after a delay of 7 days or longer. There were 9 good (60%), 1 fair (7%) and 5 poor (33%) results.
  
  
  CONCLUSIONS
  Gradual reduction by skin traction is safe. It is possible to achieve satisfactory reduction if the delay is up to 7 days. The results with regards to deformity and function were comparable with those obtained following open or closed Kirschner wire fixation.
authors.affiliation: Department of Orthopaedics, School of Medical Sciences and University Hospital, Universiti Sains Malaysia, 15990 Kubang Kerian, Kota Baru, Kelantan, Malaysia. devnani@kb.usm.my
authors.forename: A S
authors.initials: AS
authors.lastname: Devnani
mesh_terms: D002648:Child; D002675:Child, Preschool; D004550:Elbow / Q000473:pathology; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000473:pathology / Q000628:therapy*; D007103:Immobilization; D008297:Male; D016059:Range of Motion, Articular; D014143:Traction / Q000379:methods*; D016896:Treatment Outcome; D000092464:Elbow Injuries