Vaidya 2009.

Study characteristics
Methods	Design: randomised trial Study duration: January 2006 to December 2008 Power calculation: no prospective calculation of sample size
Participants	Setting: Department of Orthopaedics, Asha Hospital, Bharatpur, Nepal Sample size: 66 children Inclusion criteria: children aged 3 to 12 with Gartland 3 supracondylar fracture Exclusion criteria: delayed presentation > 4 days, previous fracture in the same limb, open fractures, fractures requiring open reduction, floating elbow, and an inability to perform an adequate neurovascular exam
Interventions	Group 1 (unclear how many children were initially allocated to this group): manipulation of fracture in theatre with fixation using retrograde wires inserted from the lateral side Group 2 (unclear how many children were initially allocated to this group): manipulation of fracture in theatre with fixation using retrograde wires inserted from the medial and lateral side. A mini‐open technique was used for the medial wire.
Outcomes	1) Nerve injury 2) Major complications 3) Cosmetic deformity measured as loss of carrying angle at 6‐month follow‐up 4) Return to function at 6‐month follow‐up 5) Radiographic deformity: loss of Baumann's angle and loss of reduction at 3 months
Notes	Loss to follow‐up: 6 children lost from randomisation to follow‐up. It is unclear to which groups these children belonged. Funding source: not stated Declarations: not stated
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "Patients were randomly selected by drawing lots with even number included in group A and odd number in group B"
Allocation concealment (selection bias)	Unclear risk	Comment: unclear if there was a fixed number of lots that could be drawn that would allow study staff to predict likelihood of next treatment allocation
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Quote: "surgery was performed by senior orthopaedic surgeon" Comment: unclear who provided the treatments and if they were involved as part of the study
Blinding of outcome assessment (detection bias)	Unclear risk	Quote: "Clinical evaluation was performed by senior orthopaedic surgeon" Comment: unclear who undertook the outcome assessment and if they were blinded to treatment allocations
Incomplete outcome data (attrition bias) All outcomes	Low risk	6 children lost from randomisation to follow‐up. It is unclear to which groups these children belonged. Final groups appear balanced
Selective reporting (reporting bias)	Unclear risk	Comment: no published protocol or prospective trial registration was identified.
Other bias	Low risk	None identified