title: Crossed Wires Versus 2 Lateral Wires in Management of Supracondylar Fracture of the Humerus in Children in the Hands of Junior Trainees.
abstract: OBJECTIVE
  The objective of this study was to evaluate and compare the outcome of the crossed and the lateral pin configurations in the management of supracondylar humeral fractures in children in the hands of junior trainees.
  
  
  METHODS
  Prospective randomized controlled trial.
  
  
  METHODS
  Level I Trauma Center.
  
  
  METHODS
  Sixty children with supracondylar humeral fractures. The mean age was 5.1 years (1.5-9 years). The minimum follow-up period was 6 months, with no patients lost to follow up.
  
  
  METHODS
  Thirty patients were managed by crossed and 30 by the lateral method. All surgeries were performed by junior trainees in their first 3 years of training.
  
  
  METHODS
  Postoperative stability, ulnar nerve injury, range of motions, and pin tract infection.
  
  
  RESULTS
  The crossed configuration was stable in all the patients, whereas the lateral method was less stable in 20% of the cases because the distal fragment rotated in 5 patients and posteriorly displaced in 1 patient. The difference was statistically significant with a P value of 0.031. Ulnar nerve neurapraxia occurred in 1 patient from the lateral group and it recovered in the fourth month, whereas no ulnar nerve injury occurred in the crossed configuration group. Two patients in the lateral group lost approximately 100 of elbow flexion.
  
  
  CONCLUSIONS
  This prospective randomized controlled trial showed that the crossed pin configuration method provided more stability than the lateral pin configuration, especially, in the hands of junior trainees in their first 3 years of training, and the difference was statistically significant.
  
  
  METHODS
  Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Cairo University Hospitals; †Tr & Orth Resident (V); and ‡Bani-Suef University Hospitals.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Abdel Karim
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hosny
authors.forename: Nasef Mohamed
authors.initials: NM
authors.lastname: Nasef Abdelatif
authors.forename: Mohamed Mahmoud
authors.initials: MM
authors.lastname: Hegazy
authors.forename: Walid R
authors.initials: WR
authors.lastname: Awadallah
authors.forename: Sherif A
authors.initials: SA
authors.lastname: Khaled
authors.forename: Mostafa A
authors.initials: MA
authors.lastname: Azab
authors.forename: Walid
authors.initials: W
authors.lastname: A ElNahal
authors.forename: Hany
authors.initials: H
authors.lastname: Mohammady
mesh_terms: D001858:Bone Nails; D001864:Bone Wires; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D007223:Infant; D007396:Internship and Residency; D008297:Male; D059348:Peripheral Nerve Injuries / Q000175:diagnosis / Q000209:etiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000209:etiology; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000293:injuries