MEDIAL AND LATERAL CROSSED-PINNING VERSUS ONLY LATERAL PINNING IN THE TREATMENT OF SUPRACONDYLAR FRACTURES OF HUMERUS A RETROSPECTIVE COMPARATIVE CLINICAL STUDY

Abstract

OBJECTIVE: In this study, we aimed to compare the clinical and radiological results of cross-pinning technique (CP) and lateral pinning technique (LP) in pediatric patients operated for supracondylar humerus fracture (SHF).MATERIAL AND METHODS: The medical records of patients undergoing operations for an SFH either with crossed-pinning technique or only lateral pining technique between the years 2017 and 2019 at the same institution were retrospectively reviewed. Age, gender, reduction type, Gartland class, duration of surgery, number of pins, postop neuro-vascular status, postoperative initial Baumann’s angle and Baumann’s angle at last follow-up visit, Lateral capitellohumeral angle, pin removal time, follow-up time, Flynn's criteria and complications (revision for fixation failure, infection, nerve palsy. nonunion, avascular necrosis ) were evaluated for all patients.RESULTS: 77 patients were included in the study. Of these, crossed-pinning (CP) technique was performed on 51 patients while only lateral pinning technique (LP) was performed on 26 patients. Among the CP group, 24 of the cross-pinned patients had undergone a medial open reduction. There was no significant difference between the groups ; in terms of the number of pins used, postoperative initial Baumann’s angle and Baumann’s angle at last follow-up visit, Lateral capitellohumeral angle, pin removal time, follow-up time, Flynn's criteria and complications(p>0,005). Nonunion, delayed union or avascular necrosis was not detected in any of the patients. However, the duration of the surgery was shorter in the LP group (p= 0,038). Iatrogenic ulnar nerve palsy was detected in four patients in the CP group and 1 fixation failure was detected in the LP group.CONCLUSIONS: Our study revealed that the results of both groups were comparable in terms of functional results. However, ulnar nerve injury was more common in patients undergoing closed reduction and percutaneous crossed-pinning. Although threre was no statistically difference in terms of complications among the groups, only lateral pinning or crossed-pinning with a limited medial open procedure may be safer for treatment of supracondylar humerus fractures.