Comparison of Treatment Methods in Gartland Type III Pediatric Supracondylar Humeral Fracture: Lateral Entry Pin versus Crossed-Pin Technique

Young-Hoon Jo; Tai-Seung Kim; Dong-Yun Kim

doi:10.12671/jkfs.2015.28.3.186

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Jo, Kim, and Kim: Comparison of Treatment Methods in Gartland Type III Pediatric Supracondylar Humeral Fracture: Lateral Entry Pin versus Crossed-Pin Technique

Original Article

Journal of the Korean Fracture Society 2015; 28(3): 186-193.

Published online: 22 July 2015

DOI: https://doi.org/10.12671/jkfs.2015.28.3.186

Comparison of Treatment Methods in Gartland Type III Pediatric Supracondylar Humeral Fracture: Lateral Entry Pin versus Crossed-Pin Technique

Young-Hoon Jo, M.D., Tai-Seung Kim, M.D., Ph.D., Dong-Yun Kim, M.D.

Department of Orthopedic Surgery, Hanyang University College of Medicine, Seoul, Korea.

Address reprint requests to: Tai-Seung Kim, M.D., Ph.D. Department of Orthopedic Surgery, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 133-791, Korea. Tel: 82-2-2290-8485, Fax: 82-2-2290-3774, kimts@hanyang.ac.kr

Received 21 April 2015 Revised 8 June 2015 Accepted 24 June 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study was to compare the results of the lateral entry pin technique and the crossed pin technique in treatment of Gartland type III humerus supracondylar fracture.

Materials and Methods

Seventeen patients (group I) underwent surgery using the lateral entry pin technique, and 33 patients (group II) underwent surgery using the crossed pin technique for Gartland type III humerus supracondylar fracture in Hanyang University Seoul Hospital between January 2011 and January 2014. Maintenance of reduction was compared between the 2 surgical techniques by measuring changes in Baumann angle and lateral humerocapitellar angle after surgery and after pin removal in groups I and II. In addition, the final carrying angle and level of loss of functional movement were measured for comparison of clinical results between the 2 groups. Occurrence of ulnar nerve palsy in the 2 groups was also examined.

Results

The mean Baumann angle and lateral humerocapitellar angle changes were 3.3° and 3.7 in group I and 3.1° and 3.4° in group II, respectively. No statistically significant differences were found between the 2 groups. Clinical results showed that the changes in the final carrying angle and range of motion were 2.9° and 2.6° in group I and 2.6° and 3.0° in group II, respectively, indicating no significant differences between the 2 groups. In terms of nerve damage, 1 patient in group II had temporary iatrogenic ulnar nerve palsy.

Conclusion

The lateral entry pin technique may be regarded as an appropriate treatment that reduces the risk of iatrogenic ulnar nerve palsy and provides satisfactory results in Gartland type III humerus supracondylar fracture patients.

Keywords: Supracondylar fracture, Lateral entry pin technique, Crossed pin technique

Figures and Tables

Fig. 1

(A) A 4-year-old boy fell outstretched and sustained an extension type III supracondylar humerus fracture, as determined by preoperative anteroposterior (AP) and lateral radiographs. (B) Closed reduction and 2 lateral pin fixation was performed. The Baumann angle and lateral humerocapitellar angle were measured using postoperative AP and lateral radiographs. (C) The Baumann angle and lateral humerocapitellar angle were re-measured using AP and lateral radiographs obtained after pin removal. Difference was calculated using the changes in Baumann angle and lateral humercapitellar angle from after the operation to after pin removal.

Fig. 2

Radiographic positioning. (A) Anteroposterior view. (B) Lateral view.

Table 1

Flynn's Criteria for Grading

Data from the article of Flynn et al. (J Bone Joint Surg Am 1974;56:263-272).14)

Table 2

Baseline Characteristics of 50 Patients with Gartland Type III Supracondylar Fractures

Values are presented as mean±standard deviation, number only, or number (%). Group I: underwent surgery with using the lateral entry pin technique, Group II: underwent surgery with using the crossed pin technique.

Table 3

Analysis of Radiologic Outcome between Lateral Pin Fixation and Crossed Pin Fixation

Values are presented as mean±standard deviation (range). Group I: underwent surgery with using the lateral entry pin technique, Group II: underwent surgery with using the crossed pin technique.

Table 4

Comparative Clinical Outcome by the Criteria of Flynn et al.14) in Both Groups^*

Values are presented as number (%). Group I: underwent surgery with using the lateral entry pin technique, Group II: underwent surgery with using the crossed pin technique. ^*p=0.921.

Notes

^{Financial support} None.

^{Conflict of interest} None.

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Similar articles

Comparison of Treatment Methods in Gartland Type III Pediatric Supracondylar Humeral Fracture: Lateral Entry Pin versus Crossed-Pin Technique

Abstract

Purpose

Materials and Methods

Results

Conclusion

Figures and Tables

Fig. 1

Fig. 2

Radiographic positioning. (A) Anteroposterior view. (B) Lateral view.

Table 1

Flynn's Criteria for Grading

Table 2

Baseline Characteristics of 50 Patients with Gartland Type III Supracondylar Fractures

Table 3

Analysis of Radiologic Outcome between Lateral Pin Fixation and Crossed Pin Fixation

Table 4

Comparative Clinical Outcome by the Criteria of Flynn et al.14) in Both Groups*

Notes

References

Comparative Clinical Outcome by the Criteria of Flynn et al.14) in Both Groups^*