Study To Compare Clinicoradiological Outcome of Two Lateral Pinning Versus Crossed Pinning in Displaced Supracondylar Fracturs of The Humerus in Children

BACKGROUND:Supracondylar fracture was described by Hippocrates during the third and fourth centuries A.D. The management of a child with displaced supracondylar fracture of humerus remains on e of the difficult problems in O rthopaedics. Supra condylar fracture of humerus are the most common elbow fracture in children. 32,40  comprising 55% to 75% of all elbow fracture mostly in left or nondominant side in the age group of 5to 10 years(30).The primary objective was to study the percutaneous pinning configuration to achieve better stability in the treatment of displaced supracondylar fractures in the children. METHODS:150patients ( divided by random sample technique) of 75 cross pinning & 75 two lateral pinning  with K-wires in extension type of supracondylar  fracture in children of <15 years classified by Gartland classification  during April 2014 to December2015 were compared for clinical and radiological outcome .The outcome was assessed according to the criteria of Flynn, Matthews and Benoit, Webb and Sherman and Boyd and Aronson. The minimum follow-up was for 6 months. RESULTS: Assessed as per the criteria of Flynn, Matthews and Benoit, Webb and Sherman and Boyd and Aronson, results were excellent in 55 cases (73.33%) and good in 13 cases (17.33%) and results were poor in 4 cases (5.33%) in Cross Pinning group and excellent in 34 cases (45.33%) and good in 27 cases (36.00%) and poor in 4 cases (5.33%) in two Lateral pinning group.  In Cross Pinning group results were excellent in 43 cases (57.33%) and good in 19 cases (25.33%) and poor in 4 cases (5.34%) and in Two Lateral Pinning group results were excellent in 32 cases (42.66%) and good in 26 cases (34.60%) and results were poor in 5 cases (6.67%) for the cosmetic factor. CONCLUSION: We conclude that cross pin fixation method is better than two lateral pin fixation while considering biomechanical stability of construct, but two lateral pinning group method is safe and away from the important structure around the elbow. It avoids the medial route and does not carry risk of iatrogenic ulnar nerve injury which is a major concern while treating supracondylar fracture of humerous in children.