Clinical Evaluation of Crossed-Pin Versus Lateral-Pin Fixation in Displaced Supracondylar Humerus Fractures

Topping, Richard E.; Blanco, John S.; Davis, Thorp J.

doi:10.1097/01241398-199507000-00004

Cited by 164 publications

(78 citation statements)

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“…According to the clinical data in our series and that of others , the use of two-three parallel or divergent lateral pins provides adequate stability, with no loss of reduction and with minimal or no risk of ulnar nerve injury, and is therefore gaining in popularity (2,(18)(19)(20).…”

Section: Discussionsupporting

confidence: 53%

A Comparative Study of Three Percutaneous Pinning Techniques for Paediatric Supracondylar Humeral Fractures

2017

ARC Journal of Orthopedics

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Section: Discussionsupporting

confidence: 53%

A Comparative Study of Three Percutaneous Pinning Techniques for Paediatric Supracondylar Humeral Fractures

2017

ARC Journal of Orthopedics

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“…Two basic techniques of pin configuration exist: a lateral entry pin technique and a medial and lateral (crossed) pin technique. Previous studies have shown that increased biomechanical stability is probably the advantage of medial and lateral entry pin fixation, although iatrogenic ulnar nerve injury may result from placement of the medial pin [27,31,34,43,53,56,60]. Conversely, lateral-only pins have been used in an attempt to avoid ulnar nerve injury, although the construct may be less stable biomechanically [8,17,26,31,34,46].…”

Section: Introductionmentioning

confidence: 99%

Is Lateral Pin Fixation for Displaced Supracondylar Fractures of the Humerus Better Than Crossed Pins in Children?

Zhao

Wang

Zhang

2013

Clinical Orthopaedics &Amp; Related Research

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Background Closed reduction and percutaneous pin fixation is considered standard management for displaced supracondylar fractures of the humerus in children. However, controversy exists regarding whether to use an isolated lateral entry or a crossed medial and lateral pinning technique. Questions/purposes We performed a meta-analysis of randomized controlled trials (RCTs) to compare (1) the risk of iatrogenic ulnar nerve injury caused by pin fixation, (2) the quality of fracture reduction in terms of the radiographic outcomes, and (3) function in terms of criteria of Flynn et al. and elbow ROM, and other surgical complications caused by pin fixation.Methods We searched PubMed, Embase, the Cochrane Library, and other unpublished studies without language restriction. Seven RCTs involving 521 patients were included. Two authors independently assessed the methodologic quality of the included studies with use of the Detsky score. The median Detsky quality score of the included trials was 15.7 points. Dichotomous variables were presented as risk ratios (RRs) or risk difference with 95% confidence intervals (CIs) and continuous data were measured as mean differences with 95% CI. Statistical heterogeneity between studies was formally tested with standard chi-square test and I 2 statistic. For the primary objective, a funnel plot of the primary end point and Egger's test were performed to detect publication bias. Results The pooled RR suggested that iatrogenic ulnar nerve injury was higher with the crossed pinning technique than with the lateral entry technique (RR, 0.30; 95% CI,. No publication bias was further detected. There were no statistical differences in radiographic outcomes, function, and other surgical complications. No significant heterogeneity was found in these pooled results. Conclusions We conclude that the crossed pinning fixation is more at risk for iatrogenic ulnar nerve injury than the lateral pinning technique. Therefore, we recommend the lateral pinning technique for supracondylar fractures of the humerus in children.

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“…In the late group, excellent result was seen in 68.4 % cases, good result in 21.1% cases and poor result in 10.5% cases. 15% of 132 Malaysian children with supracondylar fractures were reported to present late [48,49,50] . In our study arc of motion, range of motion, loss of flexion, extension and change in Baumann's angle were comparable between early and late groups with p value>0.005.…”

Section: Discussionmentioning

confidence: 99%

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2017

Int. J. Orthop. Sci.

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Purpose: Controversy still persists regarding optimum intervention time for late presentations of supracondylar fracture of humerus in children. We compared outcomes in early and late groups of presentation and management. Study design: We conducted prospective study comparing early and late open reduction and Kirschner wire fixation for Gartland type III supracondylar fracture of humerus in children aged less than 16 years. We analyzed results of 27 cases in early group and 19(8 lost) cases in late group. We compared duration of surgery, range of motion, and Flynn's criteria were used to evaluate outcome. Results: Thirty (65%) patients were male and 15(32.60%) had dominant limb involvement. Injury to surgery time was 53.63±41.03 hours in early group and 338.53±134.31 hours in late group (p<0.005). Pre-operative nerve injury was 6(13%) cases in early group. Bauman's angle at 12 weeks in early group was 70.04± 3.240 & in late group had71.42± 8.329. (p< 0.513). Loss of range of motion between groups was insignificant (p< 0.668). According to Flynn's, results were comparable between groups. Conclusion: We concludes that in cases of Garland type III supracondylar fracture of humerus of children open reduction & k-wire fixation is an effective method of treatment in both groups.

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Clinical Evaluation of Crossed-Pin Versus Lateral-Pin Fixation in Displaced Supracondylar Humerus Fractures

Cited by 164 publications

References 0 publications

A Comparative Study of Three Percutaneous Pinning Techniques for Paediatric Supracondylar Humeral Fractures

A Comparative Study of Three Percutaneous Pinning Techniques for Paediatric Supracondylar Humeral Fractures

Is Lateral Pin Fixation for Displaced Supracondylar Fractures of the Humerus Better Than Crossed Pins in Children?

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