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Intraoperative distraction in the upper extremity.

Robert E Boykin¹, Michael A Baskies, Christopher C Harrod

¹Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Techniques in Hand & Upper Extremity Surgery

|June 12, 2009

Summary

Intraoperative distraction, a technique for fracture fixation, is effective for restoring length and alignment. This paper details its application in upper extremity fractures, including the clavicle, humerus, radius, and ulna.

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Area of Science:

Orthopedic Surgery
Surgical Techniques

Background:

Intraoperative distraction is well-documented for lower extremity fractures.
Limited literature exists on its application in the upper extremity.
Fracture management often requires techniques to restore bone length and alignment.

Purpose of the Study:

To detail the technique of intraoperative distraction for upper extremity fractures.
To highlight the benefits of distraction in fracture reduction and fixation.
To address the paucity of literature on this technique in the upper limb.

Main Methods:

Description of intraoperative distraction technique.
Application of tension across the fracture site.
Use of external fixator sets for proximal and distal fixation.

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Main Results:

Intraoperative distraction restores length, aids reduction, and maintains rotational alignment.
Provides a stable temporary platform for definitive fracture fixation.
Applicable to acute fractures, malunions, and nonunions.

Conclusions:

Intraoperative distraction is a valuable technique for treating displaced upper extremity fractures.
The technique facilitates surgical management of clavicle, humerus, radius, and ulna fractures.
Further research and application in the upper extremity are warranted.