Blind pinning of displaced supracondylar fractures of the humerus in children. Sixteen years' experience with long-term follow-up.

TLDR

The technique was simplified by using a holding bracket and avoiding medial tilt of the distal fragment to prevent varus deformity. Reduction and percutaneous pinning of displaced supracondylar humeral fractures yielded stable, vascularly safe fixation, shortened hospital stays, and consistently satisfactory elbow appearance and function in 72 patients, with 98 % satisfactory outcomes in 52 long‑term follow‑ups, no growth disturbance from pins, cubitus varus arising only from imperfect reduction, and only minor vascular/neural complications and no Volkmann’s contractures.

Abstract

Reduction and percutaneous pinning of these troublesome fractures provided stability, vascular safety, simplified management, reduced hospital stay, and consistently satisfactory appearance and function of the elbow in seventy-two patients. Difficulty in mastering the technique was the only major disadvantage, and was overcome by using a simple holding bracket during the pinning. Varus deformity was prevented by avoiding medial tilt of the distal fragment. Our long-term study showed that the fixation pins do not disturb the growth potential of the distal end of the humerus. Cubitus varus, when it occurred, was a result of imperfect reduction rather than growth disturbance. In fifty-two fractures on long-term follow-up, satisfactory results were recorded in 98 per cent. Vascular and neural complications were minor, and no Volkmann's contractures were seen.