Supine Position Is Ideal for Manipulation and Pinning of All Types of Supracondylar Fractures Compared with the Prone Position

Abstract

Venkatadass K, Balachandar G, Rajasekaran S. Is Prone Position Ideal for Manipulation and Pinning of Displaced Pediatric Extension-type Supracondylar Fractures of Humerus?: A Randomized Control Trial. J Pediatr Orthop. 2014 Nov 12. ### Question: In children with displaced supracondylar humeral fractures, is there an advantage to prone versus supine positioning while performing a closed reduction and pinning of the fracture? ### Design: Randomized (allocation concealed), unblinded, controlled trial with 1 year of follow-up. ### Setting: The Ganga Hospital in Coimbatore, Tamilnadu, India. ### Patients: 52 children between 3 and 14 years of age (mean age, 7 years; 79% boys) with acute Gartland type-III fractures. Exclusion criteria were Gartland type-I and II fractures, closed physis, associated vascular injury, or open fracture. 50 patients (96%) completed the study. ### Intervention: Patients were allocated to undergo surgery in the prone (n = 26) or supine position (n = 26). One surgeon experienced in both techniques performed the surgeries. Patients in the prone group were positioned with the arm over a board and a cushion supporting the elbow. The reduction in both …