Dorgan’s lateral cross pinning for displaced pediatric supracondylar fractures of the distal humerus

Abstract

Background: Supracondylar humeral fractures are the most common elbow fracturesseen in children. Although closed reduction and percutaneous pin fixation is the treatment of choice for displaced supracondylar fractures of the humerus in children, controversy about which pin configuration is best in treating these fractures is ongoing. Some advocate lateral entry pins only while others advocate medial and lateral entry pins. In this study I utilized Dorgan’s cross lateral technique to fix such fractures which is believed to have the advantages of both the conventional pinning techniques. Objectives:To evaluate the functional and cosmetic outcome and complications of cross lateral pinning. Methods: Thirty cases of supracondylar humeral fractures were treated by closed or open reduction with cross lateral pin fixation under fluoroscopic guidance. The elbow was immobilized for a period of 4 weeks after which the pins were removed and physiotherapy initiated. At the end of 12 weeks the patients were evaluated clinically and radiologically and final results were assessed as per Flynn’s criteria. Results: According to Flynn’s criteria, the cosmetic result in my study was evaluated as excellent in 25 cases (83%) and good in 5 cases (17%) and functional result was evaluated as excellent cases in 23 (77%) and good in 7cases (23%). There were no cases of post operative loss of reduction of fractures. Six cases (20%) had pin tract infection while 24 patients (80%) had no complications at all. Conclusions: Cross lateral method of pinning for treating supracondylar fractures is a useful method of fixation as it gives stabilization like medio-lateral pinning and minimizes the risk of injuring the ulnar nerve like lateral pinning.