SynthesisJournal of orthopaedic surgery and research2018
Comparison of lateral entry with crossed entry pinning for pediatric supracondylar humeral fractures: a meta-analysis.
Synthesis in Journal of orthopaedic surgery and research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Medial-lateral versus lateral-only pinning fixation in children with displaced supracondylar humeral fractures: a meta-analysis of randomized controlled trials.Journal of orthopaedic surgery and research · 2023Pooled it
- Interventions for treating supracondylar elbow fractures in children.The Cochrane database of systematic reviews · 2022Pooled it
- Comparison of lateral entry and crossed entry pinning for pediatric supracondylar humeral fractures: a meta-analysis of randomized controlled trials.Journal of orthopaedic surgery and research · 2021Pooled it
- Modified Medial Para-Olecranon Pinning Versus Conventional Crossed Pinning for Displaced Pediatric Supracondylar Humerus Fractures: A Retrospective Comparative Cohort Study.Children (Basel, Switzerland) · 2026Article
- Comparison of Crossed Versus Lateral Pinning in Fixation of Extension Type of Supracondylar Humerus Fracture in Pediatric Age Group- A Randomized Control Trial.Indian journal of orthopaedics · 2025Article
- Proximal lateral entry technique for the treatment of supracondylar humeral fractures in children and intraoperative nerve protection: a novel technique.BMC musculoskeletal disorders · 2025Article
- K-Hammer percutaneous fixation: a novel technique for preventing iatrogenic ulnar nerve injury in pediatric supracondylar humeral fractures.Frontiers in pediatrics · 2025Article
- A Bibliometric Analysis of the Top 50 Most Cited Articles on Iatrogenic Nerve Injuries of the Upper Limb Following Surgery.Journal of brachial plexus and peripheral nerve injury · 2025Review
- Peripheral nerve injuries associated with dislocated supracondylar fractures of distal humerus in children: incidence and need of surgical treatment.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Comparative risk of ulnar nerve injury in pediatric supracondylar humeral fractures: a multicenter evaluation of Kirschner wire fixation techniques.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Complications and Outcomes of Surgically Treated Pediatric Supracondylar Humerus Fractures.Children (Basel, Switzerland) · 2024Article
- [Research progress in the treatment of distal humeral metaphyseal-diaphyseal junction fracture in children].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2024Review
- Comparative analysis of pinning techniques for supracondylar humerus fractures in paediatrics: A systematic review and meta-analysis of randomized controlled trials.Journal of orthopaedics · 2023Review
- The Effect of Fracture Patterns, Pinning Configuration, Surgeon Experience and Subspecialty on Short-Term Radiological Outcomes of Pediatric Supracondylar Humeral Fractures Treated in the Prone Position: A Case-Series.Healthcare (Basel, Switzerland) · 2023Article
- A Type IV Extension Supracondylar Fracture With Comminuted Fracture Pattern: A Case Report.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2023Article
- Correlation of Fall Height, Fracture Severity and Clinical Outcome in Pediatric Supracondylar Fractures-A Retrospective Analysis with an Observation Period of 20 Years.Children (Basel, Switzerland) · 2023Article
- Current trends in the treatment of supracondylar fractures of the humerus in children: Results of a survey of the members of European Paediatric Orthopaedic Society.Journal of children's orthopaedics · 2022Article
- A two-stage retrospective analysis to determine the effect of entry point on higher exit of proximal pins in lateral pinning of supracondylar humerus fracture in children.Journal of orthopaedic surgery and research · 2019Article
- Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe standard treatment for severe displaced pediatric supracondylar humeral fracture (SCHF) is closed reduction and percutaneous pin fixation. However, controversy persists concerning the optimal pin fixation technique. The purpose of this study was to compare the safety and efficacy on the configuration of lateral entry only with crossed entry pin fixation for SCHF, including Gartland type II and type III fractures in children.
methodsPublished literatures, including retrospective studies, prospective studies, and randomized controlled trials, presenting the probability of poor functional consequence of elbow and/or loss of reduction and/or iatrogenic ulnar nerve injury and/or superficial infection and/or cubitus varus were included. Statistical analysis was performed with the Review Manager 5.3 software.
resultsTwenty-four studies were included in the present meta-analysis involving 1163 patients with lateral entry pins and 1059 patients with crossed entry pins. An excellent score of Flynn criteria occurred more commonly in patients who treated with crossed pins than in patients with lateral pins only (RR = 0.93; 95% CI 0.87-0.99; P = 0.03). In accordance with previous systematic review, the incidence of iatrogenic ulnar nerve injury in crossed entry group was significantly more than in lateral entry group with statistical difference (RR = 0.26; 95% CI 0.14-0.47; P < 0.0001). And, results of subgroup analysis on iatrogenic ulnar nerve injury based on experimental design of retrospective study (RR = 0.23; 95% CI 0.10-0.52; P < 0.0004) and randomized control trial (RR = 0.29; 95% CI 0.10-0.79; P < 0.02) were similar.
conclusionsIn consideration of the contradictoriness of lateral entry with two pins only (possible risk of poor functional consequence of elbow) and crossed entry pins (risk of iatrogenic ulnar nerve injury), the recommended strategy for the treatment of SCHF is the lateral entry technique with introducing divergent three pins which can provide a stable configuration and avoid the injury of the ulnar nerve. And additional protective measures for the ulnar nerve should be taken by surgeons that wish for the more stable structure with the crossed entry technique.
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