Stability of Pin Fixation of Displaced Supracondylar Fractures of Humerus in Children

Roh, Kwon Jae; Kim, Dong Jun; Yun, Yeo Hon; Kim, Seong Woo

Abstract

Fifty two cases of displacecd supracondylar fractures were divided into three groups according to the methods of fracture stabilization. Cast immobilizations without pin fixation were included to the group 1 (12 cases), fixation with lateral pins to the group 2 (22 cases), and lateral and medial cross pins to the group 3 (18 cases). In each group we attempted a radiological analysis for the stabilization failure through measurements of the horizontal rotation and the mediolateral tilting in their preoperative, postoperative and follow-up X-rays. Stabilization failure during the follow-up period was presumpted to be present in those cases that show (1) a development or increase of the horizontal rotation in follow-up lateral X-ray, and (2) accompanied change in Baumann's angle of more than 5 degrees. The failed stabilizations were in three cases (25%) in the group 1. In the group 2 the horizontal rotations after initial fixation were developed in four fractures. However, only two (9%) of the four cases accompanied significant changes in the Baumann's angle. Loss of the initial fixation in the cross pin group was found in one case. These results demonstrate that the cross pin fixation is the most stable form. Fixation in only lateral side sometimes shows rotational instability, but this method seems to be still useful because singificant coronal tilting develops in only a few occasions of those with horizontal rotation.