title: Cross pinning of supracondylar fractures from a lateral approach. Stabilization achieved with safety.
abstract: OBJECTIVE
  Various pin configurations are possible to stabilize a supracondylar fracture. While cross pinning gives the best stabilty the disadvantage is the risk of iatrogenic ulnar nerve injury. We combine a cross pin fixation with a lateral approach. The aim of the study was to prove our method retrospectively to show the advantage of lateral cross-pinning achieving stabilty and avoiding ulnar nerve injury.
  
  
  METHODS
  Between 1 January 2001 and 31 December 2002, 84 supracondylar fractures were treated with invasive surgical procedure. The intention was a primary closed reduction. Following closed reduction under general anaesthesia, two K-wires were introduced from the lateral side, one ascending and the other descending. If it was not possible to perform a closed reduction, an open reduction was performed by medial-lateral crossed K-wire fixation. After either an open or closed reduction, the pins were buried under the skin. The results were evaluated using Flynn's score. The mean time of follow-up was 18.9 months.
  
  
  RESULTS
  Seventy-seven percent of the patients were treated with a closed reduction, while 23% needed an open reduction. A clinical follow-up examination was done at an average of 18.9 months following the trauma. Of those treated with a closed reduction alone, 93% had an excellent or good functional result. Of those requiring an open reduction, 88% had excellent or good result. None of our patients exhibited secondary dislocation or iatrogenic ulnar palsies.
  
  
  CONCLUSIONS
  Closed reduction and lateral crossed pin fixation with ascending and descending K-wires buried under the skin is an effective method to treat type II and III supracondylar fractures in children. The method gives stability and avoids iatrogenic ulnar nerve injuries.
authors.affiliation: Orthopaedic Department, Olgahospital Stuttgart, Bismarckstr. 8, 70176, Stuttgart, Germany, DieEberhardts@aol.com.
authors.forename: Oliver
authors.initials: O
authors.lastname: Eberhardt
authors.forename: Francisco
authors.initials: F
authors.lastname: Fernandez
authors.forename: Thomas
authors.initials: T
authors.lastname: Ilchmann
authors.forename: Klaus
authors.initials: K
authors.lastname: Parsch