Retrospective Evaluation of Two Different Percutaneous Pinning Techniques (Medial-Lateral Cross Pin vs Lateral Cross Pin) in Gartland Type 3 Pediatric Supracondylar Humerus Fractures

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Number of pages: 9-12
Year-Number: 2022-Volume: 4 Issue: 1

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Abstract

Supracondylar humerus fractures are the most common elbow injuries in children. Closed reduction percutaneous fixation is the preferred method in the treatment of pediatric supracondylar humeral fractures. The optimal pin configuration is still a matter of debate. As the most commonly used fixation method, medial-lateral cross pinning provides better stability biomechanically but there is an increased risk of ulnar nerve injury. We also used the modified Dorgan method (lateral cross pin) to minimize the risk of ulnar nerve injury and to obtain fixation with similar biomechanical stability. In this study, we compared the results of standard medial-lateral pinning and the modified Dorgan method in the treatment of Gartland type 3 supracondylar fractures. We retrospectively     analyzed 54 patients (32 males, 22 females) with pediatric supracondylar humerus fractures who were treated at the   Ankara City Hospital Orthopedics and Traumatology Clinic between 2019 and 2021 years. In clinical and functional evaluation, we evaluated joint range of motion, carrying angle, complications, Baumann angle and Flynn criteria. The mean age of the patients was 6.3 years. The most common injuries were falling while playing (64.81%), then fall from a bicycle (16.66%), traffic accidents (12.96%) and fall from a height (5.55%). The mean follow-up was 30.68 weeks (24-48 weeks). There was no ulnar or radial nerve injury or major reduction loss in any postoperative patient. Superficial pin tract infection was seen in only two cases, which resolved with simple medical interventions. According to Flynn functional criteria, the result for group 1 was excellent in 80.0% and good in 20.0% and the result for group 2 was excellent in 83.33% and good in 16.67%. There was no significant difference between the groups in terms of clinical and functional outcomes, neurovascular injury, union time. It is well known that poor sleep quality is related with depression and anxiety.

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