I would make the following points:
1. If the ED doc has limited experience, and the ortho doc has
extensive experience and is immediately available, the choice is
clear.
2. If the ortho doc is not available then return of circulation takes
priority over maintaining perfect conditions for the definitive
reduction that will be performed later
3. The primary purpose of the reduction performed in the ED is to
restore circulation. This may often be achieved by simple traction,
which is unlikely to cause significant difficulties with definitive
reduction later. Indeed, traction is used both as a definitive
treatment of displaced supracondylar fractures, and as an interim
treatment prior to delayed operative reduction.
Best wishes
Chris Kirke
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