Functional outcome of paediatric supracondylar humerus fractures treated with lateral crossed pinning and conventional crossed pinning with k-wires
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20261220Keywords:
Paediatric supracondylar fracture, Dorgan’s technique, K-wire fixation, Flynn’s criteriaAbstract
Background: Supracondylar fractures of the humerus constitute the most common paediatric elbow injuries and often require surgical fixation when displaced. Conventional medial-lateral crossed pinning offers good stability but carries a risk of iatrogenic ulnar nerve injury. Lateral crossed pinning (Dorgan’s technique) has been proposed as a safer alternative. Objectives were to compare the functional outcomes of paediatric supracondylar humerus fractures treated with lateral crossed pinning (Dorgan’s technique) and conventional medial-lateral crossed pinning.
Methods: This observational study was conducted at a tertiary care teaching hospital over 1.5 years (June 2024-December 2025). A total of 52 children (<15 years) with displaced closed supracondylar humerus fractures (Gartland type II and III) underwent closed reduction and percutaneous K-wire fixation using either lateral crossed pinning (n=28) or conventional crossed pinning (n=24). Functional outcomes were assessed at 3 and 6 months using Flynn’s criteria, elbow range of motion (EROM), and carrying angle (CSA). Statistical analysis was performed using SPSS version 26.
Results: Most patients were aged 6-10 years (51.9%), with a male predominance (69.2%). At 6 months, excellent outcomes were observed in 50.0% and good outcomes in 25.0% of patients. Mean EROM loss at 6 months was 6.52±2.1° in the lateral crossed pinning group and 6.71±2.2° in the conventional crossed pinning group (p=0.41). Mean CSA loss was 5.87±1.9° and 6.05±2.0°, respectively (p=0.064). No significant difference in functional outcomes was noted. Ulnar nerve injury occurred only in the conventional crossed pinning group.
Conclusions: Lateral crossed pinning provides comparable functional outcomes with a lower risk of ulnar nerve injury, making it a safe and effective alternative.
References
Altay MA, Erturk C, Isikan UE. Comparison of traditional and Dorgan's lateral cross-wiring of supracondylar humerus fractures in children. Saudi Med J. 2010;31(7):793-6.
Saha PK. Comparative Evaluation of Results of Cross Pin Fixation by Conventional Method with Dorgan’s Method in Displaced Supracondylar Fracture in Children. Int J Sci Stud 2015;3(6):135-9.
Nayar SP, et al. Efficacy of lateral pinning and crossed pinning in the management of displaced supracondylar fractures of humerus in children - A comparative study. IOSR J Dental and Med Sci. 2021;20(05):37-9.
Sahu RL. Percutaneous K-wire fixation in paediatric Supracondylar fractures of humerus: A retrospective study. Niger Med J. 2013;54:329-34.
Palange N, Prasanna N, Mane A, Pawar E. A comparison between percutaneous cross k wire and lateral k wires fixation in management of Type III Gartland paediatric supracondylar fractures. Int J Orthopaed Sci. 2019;5:119-22.
Jairam D, Tushar D, Ganesh D, Upadhyaya R. A comparative study of percutaneous pinning techniques (Cross K wire vs lateral K wire) for Gartland type III pediatric supracondylar fracture of the humerus. Int J Orthop Sci. 2020;6(3):226-9.
Sadek AA, Elsayed M, Elazab HEM, Abdel Rahman HH. Comparison of fixation of supracondylar humeral fractures in children by lateral cross-wiring technique versus traditional lateral pinning. Sohag Med J. 2018;22(1):265-71.
El-Hamid Shamma A, Abd El-Motalb M, El-Saied Abd El-Hamed Tash M. Lateral divergent pinning versus lateral parallel pinning in management of supracondylar fractures of the humerus in children. Al-Azhar Medical J. 2020;49(2):513-24.
Zhao JG, Wang J, Zhang P. Is lateral pin fixation for displaced supracondylar fractures of the humerus better than crossed pins in children? Clin Orthop Relat Res. 2013;471:2942-53.
Maity A, Saha D, Roy DS. A prospective randomised, controlled clinical trial comparing medial and lateral entry pinning with lateral entry pinning for percutaneous fixation of displaced extension type supracondylar fractures of the humerus in children. J Orthop Surg Res. 2012;7(1):6.
Dekker AE, Krijnen P, Schipper IB. Results of crossed versus lateral entry K- wire fixation of displaced pediatric supracondylar humeral fractures: A systematic review and meta-analysis. Injury. 2016;47(11):2391-8.
Boghdady GW, El-Adl WA, El-Said MA, Ali ASM. Results of treatment of displaced supracondylar humeral fractures in children by percutaneous lateral cross-wiring technique. Strategies Trauma Limb Reconstruct. 2008;3(1):1-7.
Sapkota K, Wahegaonkar K, Ranjeet N, Thapa P, Thapa UJ, Onta PR. Comparison of cross pinning versus lateral three pins in type three supracondylar fracture of distal humerus in children. Asian J Med Sci. 2019;10(2):58-61.
Eberhardt O, Fernandez FF, Ilchmann T, Parsch K. Cross pinning of supracondylar fractures from a lateral approach. Stabilization achieved with safety. J Children's Orthop. 2007;1:127-33.
Downloads
Published
How to Cite
Issue
Section
