A comparative study of functional outcome of criss-cross pinning vs parallel pinning for Gartland type III supracondylar humeral fractures in children in tertiary care centre

Abstract

Introduction: Supracondylar fracture of the humerus is the most frequently encountered elbow injuries among children that occupies around 60% of all elbow injuries in the initial ten years of life. Trouble in reduction and its maintenance, recurrent association of neurovascular structures injury are the common complications of displaced supracondylar fractures. Methods: Around 64 patients with displaced type III supracondylar fractures of humerus were selected who fulfilled our inclusion criteria. The method of patient selection for criss-cross pinning (GROUP-1) or parallel pinning (GROUP-2) be random. All the children with suspected supracondylar fractures of the humerus were assessed for vascular and neurological status. Clinical evaluation was graded according to carrying angle and elbow range of motion using the criteria of Flynn. Radiographic evaluation was performed at 3rd week, 6 week and at 3 and 6 months. In the 3rd week, the pins were removed. At 3-and 6-month follow-up, the children were evaluated for full function, minor limitation of function and major loss of function. Result: All the 64 subjects in our study had full range of motion postoperatively. The carrying angle in group 1 Vs group 2 was 11.18±1.99 Vs 11.96±1.92. The Baumann's angle in group 1 Vs group 2 was 71.59±3.10 Vs 71.65±2.23. Flynn et al. in group 2 with parallel all the 100% had excellent score whereas in group 1, 94% had excellent Conclusion: From our study, we concluded that the lateral pinning technique provides better functional outcome as cross pinning technique in the management of displaced supracondylar fracture of humerus in children. When compared to crossed wire pinning, lateral pinning avoids the risk of nerve injury, reduces operation time and have Flynn excellent scores.