Lateral Entry Compared with Medial and Lateral Entry Pin Fixation for Completely Displaced Supracondylar Humeral Fractures in Children

Yi-Meng Yen; Kocher, Mininder S.
March 2008
Journal of Bone & Joint Surgery, American Volume;Mar2008 Supplement, Vol. 90-A, p20
Academic Journal
BACKGROUND: Closed reduction and percutaneous pin fixation is the treatment of choice for completely displaced (type-III) extension supracondylar fractures of the humerus in children, although controversy persists regarding the optimal pin-fixation technique. The purpose of this study was to compare the efficacy of lateral entry pin fixation with that of medial and lateral entry pin fixation for the operative treatment of completely displaced extension supracondylar fractures of the humerus in children. METHODS: This prospective, randomized clinical trial had sufficient power to detect a 10% difference in the rate of loss of reduction between the two groups. The techniques of lateral entry and medial and lateral entry pin fixation were standardized in terms of the pin location, the pin size, the incision and position of the elbow used for medial pin placement, and the postoperative course. The primary study end points were a major loss of reduction and iatrogenic ulnar nerve injury. Secondary study end points included radiographic measurements, clinical alignment, Flynn grade, elbow range of motion, function, and complications. RESULTS: The lateral entry group (twenty-eight patients) and the medial and lateral entry group (twenty-four patients) were similar in terms of mean age, sex distribution, and preoperative displacement, comminution, and associated neurovascular status. No patient in either group had a major loss of reduction. There was no significant difference between the rates of mild loss of reduction, which occurred in six of the twenty-eight patients treated with lateral entry and one of the twenty-four treated with medial and lateral entry (p = 0.107). There were no cases of iatrogenic ulnar nerve injury in either group. There were also no significant differences (p > 0.05) between groups with respect to the Baumann angle, change in the Baumann angle, humerocapitellar angle, change in the humerocapitellar angle, and Flynn grade.


Related Articles

  • Medial and Lateral Percutaneous Fixation versus Lateral Fixation for Treatment of Gartland Type II, III Supracondylar Fracture of Humerus in Children. Sadik, Diaa G. // Iraqi Journal of Medical Sciences;2015, Vol. 13 Issue 2, p183 

    Background Operative treatment of supracondylar fractures with reduction and percutaneous pinning is so effective and safe. The great majority of displaced fractures should be treated operatively. There is little controversy that all closed Gartland type II and III fractures should have an...

  • Nonoperative Treatment Compared with Plate Fixation of Displaced Midshaft Clavicular Fractures. Altamimi, Sahal A.; McKee, Michael D. // Journal of Bone & Joint Surgery, American Volume;Mar2008 Supplement, Vol. 90-A, p1 

    BACKGROUND: Recent studies have shown a high prevalence of symptomatic malunion and nonunion after nonoperative treatment of displaced midshaft clavicular fractures. We sought to compare patient-oriented outcome and complication rates following nonoperative treatment and those after plate...

  • Results of Polyaxial Locked-Plate Fixation of Periarticular Fractures of the Knee. Haidukewych, George; Sems, Stephen A.; Huebner, David; Horwitz, Daniel; Levy, Bruce // Journal of Bone & Joint Surgery, American Volume;Mar2008 Supplement, Vol. 90-A, p117 

    BACKGROUND: Locked-plate fracture-fixation techniques and designs continue to evolve. Polyaxial locking plates that allow screw angulation and end-point locking have become available; however, there are no clinical data documenting their strength and efficacy, to our knowledge. The purpose of...

  • Outcomes of Posterior Wall Fractures of the Acetabulum. Moed, Berton R.; Mcmichael, Jessica C. // Journal of Bone & Joint Surgery, American Volume;Mar2008 Supplement, Vol. 90-A, p87 

    BACKGROUND: The Musculoskeletal Function Assessment (MFA) is a validated, reliable, self-administered questionnaire that is useful for determining functional status. The Merle d'Aubigné score is a clinical measure of hip function. The purpose of the present study was to evaluate the outcome...

  • Extended anterolateral approach for treatment of posterolateral tibial plateau fractures improves operative procedure and patient prognosis. Hong-Wei Chen; Cong-Feng Luo // International Journal of Clinical & Experimental Medicine;2015, Vol. 8 Issue 8, p13807 

    Purpose: The treatment of posterolateral tibial plateau fracture remains controversial and challenging. Several approaches for this fracture have been applied for direct exposure and support plate fixation. However, several structures are to be at risk via posterior approach, which may affect...

  • Osteoporotic fracture management: closing the gap of knowledge. Goldhahn, J.; Blauth, M. // Archives of Orthopaedic & Trauma Surgery;Feb2007, Vol. 127 Issue 1, p1 

    The author reflects on the increased risk of complications during osteoporosis fracture healing. The reasons for complications during the fracture treatment are largely unknown. The author comments that the journal Archives of Orthopaedic and Trauma Surgery offers informative articles on...


    The objective of this study was the identification of the therapeutic possibilities for the fractures of the distal humerus type B3.3 - classification AO. In a series of 773 cases of distal humerus fractures, only 5 cases were identified with this type of fracture. In the treatment of this type...

  • RECONSTRUCTION OF ORBITAL FLOOR FRACTURE IN HUSM. A. W., Wahid; M. A. K., Amelah; I., Omar; S., Bakiah; A. R., Noor Hayati; E., Zunaina // Malaysian Journal of Medical Sciences;Jan2006 Supplement, Vol. 13, p160 

    PURPOSE: To determine the clinical features and risk factors of orbital floor fracture and the outcome of orbital floor reconstruction in Hospital USM, Kelantan. METHOD: A five-year retrospective review of orbital fractures undergoing reconstruction surgery from 1 January 2001 until 31 December...

  • Distal radius fracture fixation with volar locking plates and additional bone augmentation in osteoporotic bone: a biomechanical study in a cadaveric model. Högel, F.; Mair, S.; Eberle, S.; Weninger, P.; Oldenburg, G.; Augat, P. // Archives of Orthopaedic & Trauma Surgery;Jan2013, Vol. 133 Issue 1, p51 

    Background: Fractures of the distal radius represent the most common fractures in adults. Volar locked plating has become a popular method for treating these fractures, but has been subject to several shortcomings in osteoporotic bone, such as loss of reduction and screw purchase. In order to...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics