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at least two more attempts at closed reduction in the emergency department before the patient’s sedation wears off.
1%
5/776
at least two attempts at closed reduction in the operating room under general anesthesia with muscle relaxation.
3%
24/776
acceptance of the reduction because the alignment is satisfactory and growth problems are rare with Salter-Harris type I fractures.
21/776
open reduction, extraction of any interposed periosteum, and smooth wire fixation to prevent nonunion.
9%
70/776
open reduction, extraction of any interposed periosteum, and smooth wire fixation to decrease the chance of premature physeal closure.
84%
648/776
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The widening of the physis associated with incomplete reduction of this fracture suggests that periosteum is interposed at the fracture site. Clinical and animal study findings suggest that the interposed periosteum may lead to premature physeal closure. Repeated forceful attempts at reduction may subject the physis to further injury and should be avoided. Growth problems are common in children with Salter-Harris type I fractures of the lower extremities. Nonunions are rare in children with Salter-Harris type I fractures.
3.5
(10)
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