Operative and Fluoroscopy Time in Pediatric Supracondylar Humeral Fracture Surgery: A Comparision Between Lateral Pinning and Cross Pinning Techniques

Objective: Although various treatment options have been described for treating this injury, in our study common types of treatment methods for 132 Gartner Type III supracondylar humerus fractures were examined.Cross pinning and Lateral Pinning (Lateral Divergent or Dorgan's Lateral pinning) methods were included and fluoroscopy time, reduction time and pinning time were examined among other parameters.Methods: From January 2013 to January 2014, we retrospectively included all children between 2 and 12 years of age who had surgery for Gartland type III supracondylar humerus fracture within 12 hours after the injury.From 132 patients, 68 patients were in cross-pinning group and 64 patients were in lateral pinning group which consisted of 31 patients in the divergent pinning and 34 patients in Dorgan's type pinning group.Minimum follow-up time was 6 months after surgery and operation time, fluoroscopy time, reduction time, pinning time, neurovascular status of the extremity before and after treatment, Flynn criteria and postoperative complications were evaluated among other parameters.Results: In both groups satisfactory results were obtained according to Flynn criteria.Application of lateral pinning techniques lasted statistically significantly longer to achieve final pinning configuration than cross-pinning group (p:0,007).Though not statistically significant fluoroscopy time and total surgery time were longer in the lateral pinning.In subgroup analysis there weren't any statistically difference in any compared parameter between lateral divergent pin placement and Dorgan's lateral pin placement.Two patients, who were treated with cross-pinning technique had ulnar palsy which completely resolved conservatively at fifth month postoperatively.Conclusion: It takes more attempt thus more time to achieve good configuration when lateral pinning methods are sellected to treat Gartland type 3 injuries.In the other hand iatrojenic ulnar nerve injury is a problem with cross pinning technique.