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Percutaneous pinning following closed reduction of supracondylar fractures is a preferred technique for management of type III injuries. If there is no pulse, rapid closed reduction with percutaneous fixation should be done. No arteriogram is indicated before treatment. Nerve damage is not a contraindication to this procedure but should be documented prior to surgery. The duration of immobilization is three to four weeks, with pins left protruding through the skin, to be removed in the office. Complications of vascular insufficiency and cubitus varus can be avoided with this technique.
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