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. 2020 Mar-Apr;11(2):259-263.
doi: 10.1016/j.jcot.2019.01.013. Epub 2019 Jan 15.

Comparison of clinic-radiological outcome of cross pinning versus lateral pinning for displaced supracondylar fracture of humerus in children: A randomized controlled trial

Syed Faisal Afaque  1 , Ajai Singh  1 , Rajiv Maharjan  2 , Rahul Ranjan  3 , Anil Kumar Panda  1 , Amitosh Mishra  1
Affiliations

Comparison of clinic-radiological outcome of cross pinning versus lateral pinning for displaced supracondylar fracture of humerus in children: A randomized controlled trial

Syed Faisal Afaque et al. J Clin Orthop Trauma. 2020 Mar-Apr.

Abstract

Introduction: Supracondylar fracture of humerus (SFH) is frequently encountered in the immature skeleton, [1] predominantly in the non-dominant extremity.

Aim: This study compared the clinic-radiological outcome between cross pinning with lateral pinning for fixation of displaced supracondylar fracture of humerus in children.

Materials and methods: All eligible patients were randomized into two groups, group I for lateral pinning and group II for cross pinning. Before passing medial pin in group II a stab incision was given to visualise the medial epicondyle. Patients were followed up on 3 weeks, 6 weeks and 3 months. Final outcome was measured in terms of clinic-radiological union, Baumann angle, loss of reduction, stability of fracture fixation, incidence of iatrogenic nerve injury and Flynn's score. Results: There were 37 patients in group I and 40 in group II. Both groups were comparable in terms of demographic details. At the final outcome there were no difference in between the groups in terms of all radiological and clinical outcome. Two patients of group I developed delay ulnar neuritis, which resolve completely in subsequent follow-up.

Conclusion: Both techniques provide stable fixation, union and good functional outcome without iatrogenic ulnar nerve injury provided that small incision sufficient enough to identify the medial epicondyle is given with passing of medial pin.

Keywords: Closed reduction; Paediatric supracondylar fractures; Pinning techniques.

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Figures

Fig. 1
Fig. 1
(a) Preoperative radiograph, 1(b) immediate post-operative radiograph showing lateral pinning configuration 1(c) radiograph after removal of K-wires at 3rd weeks, 1(d) complete remodeling at 12th month 1(e) functional outcome at 12th month.
Fig. 2
Fig. 2
(a) Preoperative radiograph, 2(b) immediate post-operative radiograph showing cross wire configuration, 2(c) radiograph after K-wire removal, 2(d) remodeling after 12 months, 2(e) final follow-up.
See this image and copyright information in PMC

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