Influence of time to surgery and pin fixation (lateral or crossed) on Flynn's criteria in Gartland type II and III supracondylar fracture: A retrospective study on 129 patients

Abstract

<b>Objectives:</b> There is a lack of consensus about the ideal pin configuration (lateral vs. crossed) and time to surgery regarding supracondylar fractures. We aim in this study to evaluate the influence of pin configuration and time to surgery on the outcome, using the Flynn criteria. <b>Methods:</b> Retrospective study of all children with supracondylar humerus fracture (SCF) Gartland types II and III treated in a single center from 2007 to 2017. Outcomes were classified as satisfactory or unsatisfactory according to Flynn's criteria at 6 weeks after surgery. Demographic, clinical, and surgical characteristics, as well as complications, were analyzed. Inferential analysis was performed by Pearson's correlation coefficient or Fisher's exact test for categorical variables when indicated. <b>Results:</b> One hundred and twenty-nine patients met the inclusion criteria. Mean patient age was 6.3 ± 2.5 years old, and 59.7% were males. Gartland type III fractures accounted for 57.4% of cases. Satisfactory outcomes occurred in 60.5% during this period. There was no difference in outcomes between the type of fixation and time to surgery. All cases of iatrogenic ulnar nerve injury occurred with crossed pin configuration. <b>Conclusion:</b> Lateral or cross fixation and time to surgery do not influence functional outcomes after surgical treatment of SCF in children, but lateral fixation decrease the risk of ulnar nerve injury.