title: Intraoperative distraction in the upper extremity.
abstract: Intraoperative distraction aids in the restoration of length, facilitates reduction, assists in maintaining rotational alignment, and provides a temporary stable platform for definitive fixation of acute fractures, malunions, and nonunions. This technique has been described at length in the lower extremity; however, there is a paucity of literature regarding its use in the upper extremity. Distraction is the application of tension across a fracture site. Proximal and distal fixation may be achieved in several ways, with common instrumentation including the use of an external fixator set. Intraoperative distraction may be invaluable in the treatment of displaced fractures of the upper extremity. The objective of this paper was to detail the technique of intraoperative distraction in the surgical treatment of fractures of the clavicle, humerus, radius, and ulna.
authors.affiliation: Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Boykin
authors.forename: Michael A
authors.initials: MA
authors.lastname: Baskies
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Harrod
authors.forename: Jesse B
authors.initials: JB
authors.lastname: Jupiter
mesh_terms: D001134:Arm Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D001858:Bone Nails; D001860:Bone Plates; D002968:Clavicle / Q000293:injuries / Q000601:surgery; D004550:Elbow / Q000601:surgery; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D015601:Injury Severity Score; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D019857:Osteogenesis, Distraction / Q000379:methods*; D011859:Radiography; D018570:Risk Assessment; D034941:Upper Extremity / Q000293:injuries / Q000601:surgery*; D014954:Wrist Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D000092464:Elbow Injuries