Biomechanical Analysis of Supracondylar Humerus Fracture Pinning for Slightly Malreduced Fractures

Abstract

Consider a 3-pin pattern, either 3 laterally divergent pins or 2 lateral pins and 1 medial pin, for SCH fractures when a less than complete anatomical reduction is obtained.

Pin Size Influences Sagittal Alignment in Percutaneously Pinned Pediatric Supracondylar Humerus Fractures

“…[6][7][8][9][10][11][12][13][14] Although numerous biomechanical 10,13,[15][16][17][18] and clinical studies [3][4][5][6][7][8][9][10][11][12][13][14]19 have documented the benefits and limitations of various pin constructs, none have adequately addressed or isolated pin size and its role in fracture fixation and complication risk. Our goal was to review our experience with Wilkinsmodified Gartland type-III pediatric SCH fractures treated with closed reduction and percutaneous pinning to evaluate the effects of pin size (through the use of a pin size ratio, comparing pin diameter to humeral midshaft cortical thickness) within 2 different pin constructs on the maintenance of reduction and the risk of surgical complications.…”

Surgical Treatment Results in Pediatric Supracondylar Humerus Fractures

“…As a result of that study, they reported that they achieved more stable fixation with three-wire configurations. Likewise, it was determined in biomechanical studies that stable fixation was obtained from cross K-wire fixation and that performing additional K-wire from the lateral side increased the stability (5,(11)(12)(13)). In the current study, we performed an application of cross K-wire and obtained more stable fixation with additional K-wire from the lateral side.…”

Lateral Pinning for Supracondylar Humerus Fracture in Children: Does The Entry Point of the Pins have an Influence on the Outcome of the Fracture Fixation?

“…Although some clinical studies have recommended maximum spread between divergent pins at the fracture to optimize stability [9,14,19] , but the literature is scant regarding the optimum entry point for the lateral pinning for the supracondylar humerus fracture to obtain maximum stability. Some biomechanical studies favor direct lateral epicondyle, extraarticular entry [4,5] , whereas others advocate capitellar or paraolecranon starting point [7,9,12] . So we decided to analyze our cases of supracondylar fracture humerus in children to resolve the basic question of: Does the entry point of the pins placed laterally have an influence on the outcome of the supracondylar humeus fracture?…”

“…Other treatment options are plate/screw fixation, external fixation and so on. Although closed manipulation and percutaneous K-wire stabilization is the gold standard for displaced supracondylar fractures of the humerus in children, optimal pin configuration is still not clear [1,[4][5][6][7] .…”

“…Several studies have tried to address the issue of lateral pin placement in the treatment of supracondylar fractures in children [4,6,7,8,[13][14][15][16][17][18] . Clinical studies have shown that double lateral pinning alone is of equal stability when compared with crossed pins for the majority of clinical fracture scenarios [6,12] .…”