Published online Mar 18, 2022. doi: 10.5312/wjo.v13.i3.250
Peer-review started: August 7, 2021
First decision: September 29, 2021
Revised: October 8, 2021
Accepted: February 12, 2022
Article in press: February 12, 2022
Published online: March 18, 2022
Processing time: 222 Days and 0.9 Hours
The most widely accepted treatment for pediatric supracondylar humeral fracture is closed reduction and percutaneous pinning (CRPP). However, there is debate regarding the technique that is utilized, whether crossed or lateral pinning, and the number of pins used.
To compare the functional and radiological outcomes of lateral and cross pinning in the management of humeral supracondylar fracture.
A retrospective analysis was performed on 101 patients who were surgically managed by either one of the CRPP techniques from 2015 to 2019. Several clinical parameters were taken into account, including pre- and post-intervention Baumann angle, as well as scores for pain, range of motion, function, and stability. Statistical analysis was performed to study the outcomes of the utilized techniques.
Amongst our study sample, which included 63 males and 38 females with a mean age of 5.87 years, about one-third of the patients underwent crossed pinning fixation configuration and the remaining two-thirds were managed by lateral pinning configuration. Similar results were obtained in the two groups with no statistical difference regarding Mayo elbow performance scores (MEPS) and Baumann angle. The mean MEPS in the lateral and crossed pinning groups were 93.68 + 8.59 and 93.62 + 9.05, respectively. The mean Baumann angle was 72.5° + 6.46 in the lateral group and 72.3° + 4.70 in the crossed-pinning group (P = 0.878).
Both lateral pinning and crossed pinning fixation configuration for displaced pediatric supracondylar humeral fractures provide similar functional and radiological outcomes.
Core Tip: Closed reduction and percutaneous pinning is the mainstay in the management of pediatric supracondylar fracture. It is still controversial what pin configuration should be used (lateral vs cross pinning), and how many pins should be used. Both lateral and cross pinning techniques provide adequate stability for the fracture with nearly similar radiological and functional outcomes.