Are the standard AP and lateral views enough to detect the rotational malalignment intraoperatively during CRPP of Gartland III pediatric supracondylar humerus fractures

Background: Displaced pediatric supracondylar humerus fractures (SCHF) can lead to residual deformity if not accurately reduced and stabilized. Most publications concerning SCHF reduction have focused on malalignment in the coronal and sagittal plane without considering the rotational malalignment. However, malrotation has been identified in 60% of patients with cubitus varus deformity following a SCHF. In addition, tardy ulnar nerve palsy has been correlated with the degree of internal rotation deformity in these patients. Intraoperatively, inability to restore anatomic rotation can narrow the corridor for intraosseous pinning and make it difficult to obtain a stable …