A prospective study of crossed versus lateral pinning for displaced extension-type supracondylar fractures of humerus

Abstract

Background: Pediatric age group has the highest incidence of supracondylar fracture of humerus, the most common being the extension type. A precise evaluation and planning is required for deciding the modality of treatment for these fractures. They are most widely managed by utilizing two methods; crossed pinning and lateral pinning. The task at hand remains to determine the superiority of either of these techniques over the other. Materials and Methods: A prospective, single blinded, randomized control trial with 68 cases, out of which 46 were boys and 22 were girls was conducted. Mean age group of study was 8.4 years. Type III supracondylar fractures were included in this study based on Gartland classification. Detailed post-operative primary assessment for major loss of reduction and iatrogenic ulnar nerve injury was done. Clinical outcome, elbow range of motion, radiographic measurement, Flynn’s grading and complications were the secondary parameters which were assessed.Results: Both groups exhibited no major loss of reduction. Change of Boumann angle was statistically insignificant. Metaphysial-Diaphysial angle, Flynn grade, carrying angle and total elbow range of motion between the two groups showed no statistically significant difference.Conclusion: Lateral pin fixation offers parallel results in terms of functional and radiological outcomes and nearly equal mechanical stability compared to medial-lateral pinning without the added shortcoming of possibility of iatrogenic ulnar nerve injury.