A Technique to Determine Proper Pin Placement of Crossed Pins in Supracondylar Fractures of the Elbow

Abstract

Supracondylar humerus fractures are the most common elbow injury in children. Stable fractures can be closed, reduced, and casted, whereas unstable fractures require percutaneous pinning. Studies have shown that there is a biomechanical advantage of crossed pin fixation as opposed to two lateral pin fixation. However, medial pin placement has the risk of injuring the ulnar nerve. This modification of technique was used on 46 patients, aged 12 months to 14 years (median age, 3.6 years). Two patients had an ulnar sensory and motor neurapraxia, and two patients had cubitus varus deformities postoperatively. Thus, a safe, easy, and reproducible technique of crossed pin fixation is described here.