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Overnight delay in the reduction of supracondylar fractures of the humerus in children.

The article by Mehlman et al. in this issue of The Journal critically evaluates the need for emergent reduction and pin fixation of type-III supracondylar fractures of the distal part of the humerus in children. Those of us who treat a large number of these fractures have traditionally considered them to require immediate reduction and fixation to prevent or substantially reduce the risk of complications such as compartment ischemia and to increase the likelihood that closed reduction will be successful. Prior to the 1999 report by Iyengar et al.1, these fractures had been treated as an emergency.

Mehlman et al. performed a double-cohort study of 220 consecutive pediatric patients who had been treated operatively for a displaced supracondylar fracture of the distal part of the humerus. They excluded patients …