Clinical evaluation of crossed-pin versus lateral-pin fixation in displaced supracondylar humerus fractures.

The radiographs and patient charts of 47 children treated with closed reduction and percutaneous pin fixation of displaced supracondylar humerus fractures were reviewed. Twenty-seven fractures were fixed with crossed medial and lateral pins. Twenty fractures were treated with two parallel laterally placed pins. Baumann's angle on the anteroposterior elbow film and the humerocapitellar angle on the lateral elbow film were independently measured by the three authors on initial postoperative films and on films taken at the time of pin removal. No statistically significant differences regarding maintenance of reduction were found when comparing the two fixation groups. There were two complications in the medial pin group (one cubitus varus and one ulnar nerve injury) and none in the lateral-pin group. We conclude that crossed-pin fixation offers no clinically significant advantage over two laterally placed pins in the treatment of supracondylar humerus fractures.