BACKGROUND
Supracondylar humerus fracture (SCHF) is common injury in children where displaced type 3 and 4 types require reduction and K wire fixation. But the use of lateral only or crossed pinning configuration is debatable.
METHODS
A prospective comparative study was conducted for a period of two year (2021 and 2022) at National Trauma Center, Nepal in patients less than 16 years presenting with closed Gartland type 3 and 4 supracondylar humeral fracture. Cases were randomly assigned to crossed pinning (CP) and lateral pinning (LP) with K wires after closed reduction of SCHF. Functional outcome, complications, loss of reduction and Baumann angle was assessed at 3 months follow up.
RESULTS
Total of 80 cases were enrolled. Lateral pinning and cross pinning had 32 and 48 assigned respectively. The groups were comparable in terms of age, gender, mechanism of injury, types and duration of injury. The mean age was 6.40 years (SD 1.36), ranging from 4 to 9 years. CP had longer surgery duration (p = 0.000). Ulnar neuropraxia was present in 3 cases (3.8%) of CP, whereas LP had none. The Flynn’s criteria, time to union, loss of Bauman angle and loss of elbow motion were comparable between groups.
CONCLUSION
The lateral or crossed pinning in type 3 and 4 SCHF have similar radiological and functional outcomes. The Ulnar neuropraxia was present in CP groups but overall complications were comparable between both groups.
KEYWORDS
closed fracture reduction; kirschner wires; nerve injury; supracondylar distal humerus fractures; ulnar nerve