TechniqueRepurposing Spinal Distractor to Reduce Pediatric Wrist FracturesUppal, Harjot S. MBA*; Biama, Richard A. MD† Author Information *Albany Medical College, Albany NY †Loma Linda University, School of Medicine, Loma Linda CA Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding. Address correspondence and reprint requests to Harjot S. Uppal, MBA, 17 New Scotland Avenue, Apt 301, Albany, NY 12208. E-mail: [email protected]. Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www.techhandsurg.com. Techniques in Hand & Upper Extremity Surgery: November 17, 2022 - Volume - Issue - 10.1097/BTH.0000000000000416 doi: 10.1097/BTH.0000000000000416 Buy SDC PAP Metrics Abstract Fracture geometry, particularly a jagged bone spike, can present a physical barrier in closed reduction of pediatric distal radius-ulna fractures. When closed reduction of the fracture is not possible, accepting an incomplete reduction and hoping for remodeling, or open reduction, which poses a greater risk for infection and potential physeal injury, are alternative treatment options. The objective of this study was to describe a technique, coined as Percutaneous Skeletal Traction Aided Reduction (P_STAR), for reducing these fractures, thereby eliminating the acceptance of an incomplete reduction and the risks associated with open reduction. In P_STAR, 2 distraction pins are placed 1.5 cm proximal and distal to the fracture site in clearance of the distal radial physis. A shadow-line spinal distractor is then used to distract the pins, reducing the fracture over the irregular impeding fracture geometry. After distraction is released, 1 or 2 K-wires can be percutaneously inserted to transfix the fracture. A video of the technique was also included as Supplemental Digital Content, https://links.lww.com/BTH/A188. When performed on 18 children with distal radius-ulna fractures, P_STAR achieved near anatomic fracture alignment with no nerve or tendon injury, infection, or refracture. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.