Cross Pinning Versus Lateral Pinning in Supracondylar Fractures of Humerus in Children -Outcome Analysis in Southern India

Abstract

Background: Supracondylar humerus fractures (SHF) account for major elbow fractures
observed among the paediatric population. The most commonly used treatment methods are
crossed medial and lateral pinning and lateral pinning alone.
Methods: The present study was conducted in Department of Orthopaedics, Government
Villupuram medical college, 42 cases of displaced supracondylar fractures of humerus in
children were treated with cross pinning and lateral pinning with Kirschner wires according to
surgeons’ preference. The supracondylar fractures were classified based on Modified Gartland
classification.
Results: The fractures were common among males (52.4%) and also a left sided predominance
was observed. Majority of the patients were aged less than10 years. We observed that among the cross pinned cases 11 cases developed limitation of terminal flexion. While in the lateral pinned cases 17 had limitation of terminal flexion. Among the cross pinned patients 9 had excellent and 10 cases had good results. Among the lateral pinned cases 12 had excellent results, 8 had good results and 3 had fair results. No patient in cross pinning as well as in lateral pinning group had any loss of reduction. Post-operative partial ulnar nerve injury and pin site infection was observed in the cross pinned groups.
Conclusion: Cross pinning is the most stable configuration in maintaining the reduction of supra condylar fracture of humerus in children than lateral pinning. Cross pinning has a definitive risk iatrogenic ulnar nerve injury in spite of taking precautions to protect the nerve than lateral pinning.