J Korean Fract Soc.  2015 Jul;28(3):186-193. 10.12671/jkfs.2015.28.3.186.

Comparison of Treatment Methods in Gartland Type III Pediatric Supracondylar Humeral Fracture: Lateral Entry Pin versus Crossed-Pin Technique

• Jo YH
• Kim TS
• Kim DY

• KMID: 2184416
• DOI: http://doi.org/10.12671/jkfs.2015.28.3.186

Abstract

PURPOSE
The aim of this study was to compare the results of the lateral entry pin technique and the crossed pin technique in treatment of Gartland type III humerus supracondylar fracture.
MATERIALS AND METHODS
Seventeen patients (group I) underwent surgery using the lateral entry pin technique, and 33 patients (group II) underwent surgery using the crossed pin technique for Gartland type III humerus supracondylar fracture in Hanyang University Seoul Hospital between January 2011 and January 2014. Maintenance of reduction was compared between the 2 surgical techniques by measuring changes in Baumann angle and lateral humerocapitellar angle after surgery and after pin removal in groups I and II. In addition, the final carrying angle and level of loss of functional movement were measured for comparison of clinical results between the 2 groups. Occurrence of ulnar nerve palsy in the 2 groups was also examined.
RESULTS
The mean Baumann angle and lateral humerocapitellar angle changes were 3.3degrees and 3.7 in group I and 3.1degrees and 3.4degrees in group II, respectively. No statistically significant differences were found between the 2 groups. Clinical results showed that the changes in the final carrying angle and range of motion were 2.9degrees and 2.6degrees in group I and 2.6degrees and 3.0degrees in group II, respectively, indicating no significant differences between the 2 groups. In terms of nerve damage, 1 patient in group II had temporary iatrogenic ulnar nerve palsy.
CONCLUSION
The lateral entry pin technique may be regarded as an appropriate treatment that reduces the risk of iatrogenic ulnar nerve palsy and provides satisfactory results in Gartland type III humerus supracondylar fracture patients.

Keyword

Supracondylar fracture; Lateral entry pin technique; Crossed pin technique

MeSH Terms

Humans
Humeral Fractures*
Humerus
Range of Motion, Articular
Seoul
Ulnar Neuropathies

Figure

• 

  Fig. 1 (A) A 4-year-old boy fell outstretched and sustained an extension type III supracondylar humerus fracture, as determined by preoperative anteroposterior (AP) and lateral radiographs. (B) Closed reduction and 2 lateral pin fixation was performed. The Baumann angle and lateral humerocapitellar angle were measured using postoperative AP and lateral radiographs. (C) The Baumann angle and lateral humerocapitellar angle were re-measured using AP and lateral radiographs obtained after pin removal. Difference was calculated using the changes in Baumann angle and lateral humercapitellar angle from after the operation to after pin removal.

• 

  Fig. 2 Radiographic positioning. (A) Anteroposterior view. (B) Lateral view.

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