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Time to treatment: the question of beneficial surgical delays.

To The Editor: 

In their article “The Effect of Surgical Timing on the Perioperative Complications of Treatment of Supracondylar Humeral Fractures in Children” (83-A: 323-7, March 2001), Mehlman et al. concluded that their findings did not support the contention that emergent treatment of these fractures is necessary to prevent complications. However, in the delayed-treatment group, 102 of 146 patients had a Gartland type-III fracture and approximately 50% of the 146 had an emergent closed reduction in the emergency department because of extreme displacement with or without markedly tented skin.

It appears that the authors had three different treatments for patients with Gartland type-III fractures. The early-treatment group had forty-nine of these …