The Outcome of Closed Reduction and Total Lateral Entry Crossed Pin Fixation of Unstable Type III Pediatric Supracondylar Humerus Fractures

Abstract

Background: Supracondylar humerus fracture is the most common elbow fracture in children. While closed reduction and percutaneous pining is the standard treatment method, the ideal pin arrangement is controversial.
Objectives: The current study aimed at evaluating the outcome of the closed lateral cross-pinning to treat displaced supracondylar humeral fractures. Patients and method: After closed parallel lateral pin fixation, reduction was unstable in 35 patients, who underwent cross- pinning from lateral entry point. The mean follow-up period was 6 months and all patients were evaluated for the loss of reduction, iatrogenic ulnar nerve injury, and elbow range of motion.
Results: The mean age of the patients was 7 years. All fractures were type III according to the Gartland classification. There was no case of reduction loss or iatrogenic ulnar nerve injury. Elbow range of motion was full. Two patients had malreduction.
Conclusions: Although medial and lateral cross-pinning has the highest stability of pinning techniques, the risk of iatrogenic ulnar nerve injury is significant. Total lateral entry cross-pin fixation method of pediatric supracondylar humerus fractures has similar results to the conventional cross-pin methods regarding the fixation stability, but with lower ulnar nerve injury cases.