The cases of 230 patients who had a displaced extension-type
supracondylar fracture of the humerus were reviewed retrospectively. The
results of treatment by four different methods were assessed clinically and
compared. The mean length of follow-up was 4.6 years (range, one to nine
years). The highest percentages of excellent results were achieved by
percutaneous Kirschner-wire fixation (78 per cent), skeletal traction (67
per cent), and open reduction with internal fixation (67 per cent). Closed
reduction and application of a cast was associated with a significantly
lower percentage of early and late complications, including Volkmann
ischemic contracture and cubitus varus. It is recommended that treatment
with a cast be reserved for undisplaced fractures only. Percutaneous
Kirschner-wire fixation is advocated as the method of choice for the
majority of displaced fractures.