Summary_of_Recs.pdf

AAOS Clinical Practice Guidelines Unit v1.0_092311 iii Summary of Recommendations The following is a summary of the recommendations in the AAOS’ clinical practice guideline, The Treatment of Pediatric Supracondylar Humerus Fractures. This summary does not contain rationales that explain how and why these recommendations were developed nor does it contain the evidence supporting these recommendations. All readers of this summary are strongly urged to consult the full guideline and evidence report for this information. We are confident that those who read the full guideline and evidence report will see that the recommendations were developed using systematic evidence-based processes designed to combat bias, enhance transparency, and promote reproducibility. This summary of recommendations is not intended to stand alone. Treatment decisions should be made in light of all circumstances presented by the patient. Treatments and procedures applicable to the individual patient rely on mutual communication between guardian and physician as well as other healthcare practitioners. 1. We suggest nonsurgical immobilization of the injured limb for patients with acute (e.g. Gartland Type I) or non displaced pediatric supracondylar fractures of the humerus or posterior fat pad sign Strength of Recommendation: Moderate 2. We suggest closed reduction with pin fixation for patients with displaced (Gartland Type II and III, and displaced flexion) pediatric supracondylar fractures of the humerus. Strength of Recommendation: Moderate 3. The practitioner might use two or three laterally introduced pins to stabilize the reduction of displaced pediatric supracondylar fractures of the humerus. Considerations of potential harm indicate that the physician might avoid the use of a medial pin. Strength of Recommendation: Weak 4. We cannot recommend for or against using an open incision to introduce a medial pin to stabilize the reduction of displaced pediatric sup