Repair of supracondylar humerus fractures in children: does pin spread matter?

Supracondylar humerus fractures occur frequently in children and can be repaired by the lateral or crossed pinning technique, although the importance of pin divergence is unknown. A surgeon's experience using the crossed (N=46) and lateral (N=57) pinning technique was reviewed to determine whether the pin-spread ratio (PSR), the distance between the pins at fracture level divided by the fracture width, was associated with fixation loss. No association existed between the PSR and change in Baumann's angle for fractures repaired by lateral pinning, although one existed for type III fractures repaired with crossed pinning. The PSRs employed in pediatric supracondylar humerus repair appear sufficient for fixation.