Assessment of Using Three laterals Diverting Pins Versus Medial and lateral Crossing Pins for Fixation of Displaced Supracondylar Fracture Humerus in Children: A Randomized Study | ||
| The Egyptian Orthopaedic Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 30 July 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/eoj.2025.396846.1053 | ||
| Authors | ||
| Mohamed Zakaria Mohamed Attia* 1; Mohamed osama Hegazy2; Mohamed Hussein Fadel3 | ||
| 1helwan university | ||
| 2Faculty of Medicine Banha University | ||
| 3Faculty of Medicine, Helwan University, Cairo, Egypt. | ||
| Abstract | ||
| Background: Supracondylar fracture humerus (SCFH) is one of the most common pediatric fractures in orthopedics practice, representing around 3-7 % of all pediatrics fractures. We aimed to evaluate the results of treatment of SCFH with three divergent lateral pins fixation versus two crossing pins fixation regarding biomechanical stability and Iatrogenic ulnar nerve injury. Methods: This randomized prospective comparative intervention study was carried out on 30 children of < 11 years old, with recently closed fracture, Gartland classification type II or type III SCFH, and had no compromised neurovascular state SCFH. Cases were operated on Helwan University hospitals and Electricity Hospital. Patients were randomly divided into two equal groups; group (A) were treated by three lateral diverting pins and group (B) were treated by medial and lateral crossing pins. All children underwent clinical examination (Inspection, palpation, range of motion), radiological evaluation with plain radiography, and preoperative laboratory investigations. Results: Group (A) demonstrated significantly higher operative time and number of images intensifiers than Group (B) (P<0.05). The final result revealed that there was no significant difference between the two studied groups, regarding the biomechanical stability of the construct in both groups, there is no loss of reduction occurred. Iatrogenic ulnar nerve injury occurred in one patient in group (B). Conclusions: Three lateral diverting fixation technique is a welcomed addition to the repertoire of treatment modalities addressing SCFH fractures in children as this procedure showed improvement in the overall functional outcome beside it is safe in avoiding iatrogenic ulnar nerve injury. | ||
| Keywords | ||
| distal; pediatric; Humerus fracture | ||
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