title: A comparative study of two closed reduction methods for pediatric supracondylar humeral fractures.
abstract: BACKGROUND
  No randomized controlled studies have confirmed the advantages of the joystick technique over the traditional manual traction. The objective of this study was to compare the results of the joystick technique and the traditional manual traction for facilitating closed reduction of pediatric supracondylar humeral fractures.
  
  
  METHODS
  From February 2009 to December 2012, sixty eight children were included in this study. Group A included 34 fractures reduced by the joystick technique. Group B consisted of 34 fractures reduced by the traditional manual traction. Preoperative demographic data were comparable between the two groups. The operative time, fluoroscopy time, hospitalization time, time to bone union, complications were recorded in both groups. Radiologic and functional results were assessed using the Flynn scoring system.
  
  
  RESULTS
  Closed reduction was successfully done in all the fractures of Group A while traditional closed manipulation was successfully done in 25 fractures of Group B and 9 fractures failed. There was a significant difference between the two groups in the rate of failed closed reduction (P = 0.004). The mean operative time was 30.5 ± 9.0 and 48.2 ± 16.4 min, and the mean fluoroscopy time was 25.4 ± 10.5 s and 55.0 ± 21.2 s in Group A and Group B, respectively. Both the operative time and fluoroscopy time were significantly longer in Group B (P < 0.001 and 0.001, respectively). However, there was no significant difference in terms of the mean hospitalization time, mean union time, total complications, the Flynn scores between the two groups (P > 0.05).
  
  
  CONCLUSIONS
  The joystick technique should be chosen to facilitate closed reduction if traditional manual traction failed to yield an acceptable reduction.
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital & Yuying Children' Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Yue-Li
authors.initials: YL
authors.lastname: Zhu
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital & Yuying Children' Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Hu
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital & Yuying Children' Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Xian-Bin
authors.initials: XB
authors.lastname: Yu
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital & Yuying Children' Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China. Electronic address: wys9453@163.com.
authors.forename: Yao-Sen
authors.initials: YS
authors.lastname: Wu
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital & Yuying Children' Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China. Electronic address: sunlj797110@163.com.
authors.forename: Liao-Jun
authors.initials: LJ
authors.lastname: Sun
mesh_terms: D002648:Child; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D015601:Injury Severity Score; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D061646:Operative Time; D010372:Pediatrics; D011859:Radiography / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D014143:Traction / Q000379:methods; D016896:Treatment Outcome; D000092464:Elbow Injuries