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Intraoperative Distraction in the Upper Extremity

Boykin, Robert E. MD; Baskies, Michael A. MD; Harrod, Christopher C. MD; Jupiter, Jesse B. MD

Techniques in Hand & Upper Extremity Surgery: June 2009 - Volume 13 - Issue 2 - p 75-81
doi: 10.1097/BTH.0b013e31818f0730

Intraoperative distraction aids in the restoration of length, facilitates reduction, assists in maintaining rotational alignment, and provides a temporary stable platform for definitive fixation of acute fractures, malunions, and nonunions. This technique has been described at length in the lower extremity; however, there is a paucity of literature regarding its use in the upper extremity. Distraction is the application of tension across a fracture site. Proximal and distal fixation may be achieved in several ways, with common instrumentation including the use of an external fixator set. Intraoperative distraction may be invaluable in the treatment of displaced fractures of the upper extremity. The objective of this paper was to detail the technique of intraoperative distraction in the surgical treatment of fractures of the clavicle, humerus, radius, and ulna.

From the Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Received September 3, 2008, and in revised form September 24, 2008.

Accepted for publication September 24, 2008.

Address correspondence and reprint requests to Jesse B. Jupiter, MD, Yawkey Center, Suite 2100, 55 Fruit St, Boston, MA 02114. E-mail:

The authors have no financial disclosures.

© 2009 Lippincott Williams & Wilkins, Inc.