Lateral pinning bests cross-pinning for treating pediatric extension-type supracondylar humerus fractures: Study

Dr Supreeth  D R

Lateral pinning bests cross-pinning for treating pediatric extension-type supracondylar humerus fractures: Study

Written By : Dr Supreeth D R Published On 2025-12-10T20:00:12+05:30 | Updated On 10 Dec 2025 8:00 PM IST

Various techniques for fixation of pediatric supracondylar humerus fracture have been in practice, but which is a better option is still controversial.

Eswaran Mythilisri et al conducted a study to compare the functional and radiological outcomes of pediatric supracondylar humerus fracture fixed by percutaneous cross-pinning or lateral pinning.

The authors conducted a prospective, single-blinded, randomized control trial with 60 patients divided into two groups of 30 each, ages ranging from less than one year to 13 years, with Gartland type 2 or 3 supracondylar humerus fractures.The outcome of fracture fixation treated with either crossed or lateral pinning was assessed with a six-month follow-up by comparing the pre-operative and post-operative Baumann angle, post-operative carrying angle and the Flynn criteria.

The key findings of the study were:

• The age range was 3–9 years in both groups.

• Gartland type 3 supracondylar humerus fracture was most commonly noted in group A (19 patients) and type 2 fracture was noted more commonly in group B (16 patients).

• There was no significant difference in the radiological outcome of the supracondylar humerus fracture fixed with percutaneous cross-pinning or lateral pinning.

• No patient had any iatrogenic ulnar nerve injury.

• All 60 patients had excellent Flynn criteria at the end of the six-month follow-up.

The authors concluded – “both the techniques of percutaneous pinning, i.e., cross-pinning and lateral-pinning, showed comparable bony union. However, the functional outcomes were better at 3 months follow-up in the lateral-pinning group compared to cross-pinning. Nonetheless, at 6 months after surgery there were no differences in the outcomes in both the groups. Though the duration of surgery was not statistically significant between the groups, cross-pinning group was found have a longer time for fracture fixation. The trans-olecranon technique of fixation can be adopted as it has been shown to provide superior stability with four cortical purchases. However, more research on this technique is warranted.”

MBBS, Dip. Ortho, DNB ortho, MNAMS

Dr Supreeth D R (MBBS, Dip. Ortho, DNB ortho, MNAMS) is a practicing orthopedician with interest in medical research and publishing articles. He completed MBBS from mysore medical college, dip ortho from Trivandrum medical college and sec. DNB from Manipal Hospital, Bengaluru. He has expirence of 7years in the field of orthopedics. He has presented scientific papers & posters in various state, national and international conferences. His interest in writing articles lead the way to join medical dialogues. He can be contacted at editorial@medicaldialogues.in.