Slide 119 — AAOS guideline 2015

Clean FRCS notes with inline figures

•Strength of Recommendation: Moderate

•closed reduction with pin fixation - displaced (Type II and III, and displaced flexion)

•Strength of Recommendation: Weak

•use two or three laterally introduced pins. Considerations of potential harm indicate that the physician might avoid the use of a medial pin.

•might perform open reduction for displaced fractures with varus or other malposition after closed reduction

•Inconclusive

•using an open incision to introduce a medial pin

•time threshold for reduction of displaced fractures without neurovascular injury

•open exploration of the antecubital fossa in patients with absent wrist pulses but with a perfused hand after reduction

•optimal time for removal of pins and mobilization

•routine supervised physical or occupational therapy

•optimal time for allowing unrestricted activity after injury

•recommend optimal timing of or indications for electrodiagnostic studies or nerve exploration in patients with nerve injuries

•open reduction and stable fixation for adolescent patients with supracondylar fractures

•Consensus

•emergent closed reduction for patients with decreased perfusion of the hand.

•open exploration of the antecubital fossa for patients who have absent wrist pulses and are underperfused after reduction and pinning

#	semantic level	rewritten line
1	0	AAOS guideline 2015
2	1	Strength of Recommendation: Moderate
3	1	nonsurgical immobilization - acute non displaced (e.g. Gartland Type I)
4	1	closed reduction with pin fixation - displaced (Type II and III, and displaced flexion)
5	1	Strength of Recommendation: Weak
6	1	use two or three laterally introduced pins. Considerations of potential harm indicate that the physician might avoid the use of a medial pin.
7	1	might perform open reduction for displaced fractures with varus or other malposition after closed reduction
8	1	Inconclusive
9	1	using an open incision to introduce a medial pin
10	1	time threshold for reduction of displaced fractures without neurovascular injury
11	1	open exploration of the antecubital fossa in patients with absent wrist pulses but with a perfused hand after reduction
12	1	optimal time for removal of pins and mobilization
13	1	routine supervised physical or occupational therapy
14	1	optimal time for allowing unrestricted activity after injury
15	1	recommend optimal timing of or indications for electrodiagnostic studies or nerve exploration in patients with nerve injuries
16	1	open reduction and stable fixation for adolescent patients with supracondylar fractures
17	1	Consensus
18	1	emergent closed reduction for patients with decreased perfusion of the hand.
19	1	open exploration of the antecubital fossa for patients who have absent wrist pulses and are underperfused after reduction and pinning