LATERAL ENTRY PINNING AND CROSSED ENTRY PINNING IN PEDIATRIC SUPRACONDYLAR HUMERAL FRACTURES GARTLAND TYPE III

Document Type : Original Article

Authors

1 Department of Orthopaedic Surgery, Faculty of Medicine - Ain Shams University, Cairo, Egypt.

2 Resident Orthopaedic Surgery at Berkat El Saba General Hospital, Egypt.

Abstract

Background: Supracondylar humeral fracture is a very common pediatric trauma disorder. It is very common between four and eleven years, more in boys than girls and left side affected more than right one. Major cases are extension type, which is sub classified according to Garteland classification by severity diagnosed radiologically through plain x-rays. Displaced fractures usually need fixation to avoid functional and cosmetic complications.
Aim of the Work: This systematic review of literature and meta-analysis is conducted to compare between two methods of closed pinning of Gartland’s III supra-condylar humeral fractures comparing lateral entry wires and crossed wires according to ulnar nerve injury and post-operative clinical and radiological outcomes.
Patient and Method: Recent after 2000 clinical trials or cluster trials, prospective and retrospective comparative cohort studies. Search results will be uploaded to systematic review management software and manually screened for eligibility to be included. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart will be introduced on the search results.
Data Sources: Medline databases (PubMed, Medscape, Science Direct. EMF-Portal) and all materials available in the Internet till 2020.
Results: Closed reduction and per-cutaneous pinning, of supracondylar humeral fractures in children by lateral only and crossed medial and lateral wires result in similar construct stability and functional outcome, and there was significant difference between the two managements as for the complications of ulnar nerve injury which is higher in crossed pinning.
Conclusion: Lateral pinning with proper technique for sake of safety and to minimize risk of ulnar nerve injury in addition to adequate stability if proper pin fixation principles are used.

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