Publication:

Functional outcome of paediatric supracondylar humerus fractures treated with lateral crossed pinning and conventional crossed pinning with k-wires

Background Supracondylar fractures of the humerus constitute the most common paediatric elbow injuries and often require surgical fixation when displaced. Conventional medial-lateral crossed pinning offers good stability but carries a risk of iatrogenic ulnar nerve injury. Lateral crossed pinning (Dorgan’s technique) has been proposed as a safer alternative. Objectives were to compare the functional outcomes of paediatric supracondylar humerus fractures treated with lateral crossed pinning (Dorgan’s technique) and conventional medial-lateral crossed pinning.

Methods This observational study was conducted at a tertiary care teaching hospital over 1.5 years (June 2024-December 2025). A total of 52 children (<15 years) with displaced closed supracondylar humerus fractures (Gartland type II and III) underwent closed reduction and percutaneous K-wire fixation using either lateral crossed pinning (n=28) or conventional crossed pinning (n=24). Functional outcomes were assessed at 3 and 6 months using Flynn’s criteria, elbow range of motion (EROM), and carrying angle (CSA). Statistical analysis was performed using SPSS version 26.

Results Most patients were aged 6-10 years (51.9%), with a male predominance (69.2%). At 6 months, excellent outcomes were observed in 50.0% and good outcomes in 25.0% of patients. Mean EROM loss at 6 months was 6.52±2.1° in the lateral crossed pinning group and 6.71±2.2° in the conventional crossed pinning group (p=0.41). Mean CSA loss was 5.87±1.9° and 6.05±2.0°, respectively (p=0.064). No significant difference in functional outcomes was noted. Ulnar nerve injury occurred only in the conventional crossed pinning group.

Conclusions Lateral crossed pinning provides comparable functional outcomes with a lower risk of ulnar nerve injury, making it a safe and effective alternative.