Outcome analysis of cross pinning in supracondylar fractures of humerus in children

Abstract

Background: Supracondylar humerus fractures are one of the commonest fractures in the paediatric age group. Displaced supracondylar fractures of humerus in children is commonly treated by closed or open reduction and K wire fixation. Cross pinning and lateral pinning are the commonest configurations used for fixation. The configuration of wires is debatable although cross pinning is biomechanically more stable, there is a risk of iatrogenic ulnar nerve injury. Recent studies suggest lateral pinning if properly done has equal stability and there is no risk of iatrogenic ulnar nerve injury. functional outcome of displaced supracondylar fractures of humerus in children treated with cross pinning Inclusion criteria included Age less than 16 yrs, Gartland type II and type III fractures and Cases managed by closed or open reduction and stabilized by Kirschner wires. Patient with Age more than 16 years, Gartland type I fractures, Compound fractures, Patient presenting with associated neurolovascular deficit were excluded.Materials and Methods: This is a randomized prospective study from November 2019 to April 2021. A total of 30 patients of displaced supracondylar fracture aged between 2-12 years without any compound injury were enrolled for the study. The cosmetic and functional outcomes were evaluated by Modified Flynn’s criteria.Results: As per Modified Flynn’s criteria, all patients treated with cross pinning had satisfactory results. There was no statistically significant difference with regard to functional outcome, cosmetic outcome and loss of reduction. There was one case of iatrogenic ulnar nerve injury in cross pinning group.Conclusion: cross pinning provides good stability and functional outcome. Cross pinning has a definitive risk of iatrogenic ulnar nerve injury.