ArticleJournal of orthopaedic surgery and research2019
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.
Article in Journal of orthopaedic surgery and research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed.
- A Pediatric Supracondylar Fracture with Bilateral (Medial and Lateral) Pillar Comminution-A Recommendation for a New Stable Pin Configuration for a Highly Unstable Fracture.Pediatric reports · 2026Article
- Effect of fracture level on optimal Kirschner wire configuration in pediatric supracondylar humerus fractures: A finite element analysis.Joint diseases and related surgery · 2025Article
- Modern Treatment of Supracondylar Humeral Fractures in Children.Children (Basel, Switzerland) · 2025Review
- Fixation for metaphyseal-diaphyseal junction noncomminuted fracture of the distal humerus in children: K-wire or ESIN, how to decide?Frontiers in pediatrics · 2025Article
- [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
- Article
- Supracondylar Humerus Fractures: Classification Based Treatment Algorithms.Indian journal of orthopaedics · 2021Review
- Closed Reduction and Percutaneous Pinning in the Treatment of Humeral Distal Metaphyseal-Diaphyseal Junction Fractures in Children: A Technique Note and Preliminary Results.Frontiers in pediatrics · 2021Article
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6 authors.
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Abstract
backgroundKirschner wire fixation remains to be the mainstream treatment modality in unstable or displaced supracondylar humerus fracture in children, with divergent lateral pins being the most preferred due to their sufficient stability and decreased risk of ulnar nerve injury. However, the entry point at which the proximal lateral pin can be inserted to achieve a more proximal exit and maximum divergence has not been reported. This study retrospectively analyzed the characteristics and factors influencing the entry and exit points of the proximal lateral pins.
methodsThe study was divided into two stages. In stage one, the entry and exit points of the proximal pins of lateral pinning configuration were analyzed from intra-operative radiographs of children treated for extension-type supracondylar humerus fractures. The coronal and sagittal pin angles formed by the proximal pins were also measured. Using the findings of stage one, we intentionally tried to achieve a more proximal exit with the proximal pins in stage two. Comparisons between groups of patients treated by random and intentional pinnings were done statistically.
resultsIn the first stage, 47 (29.2%) of the 161 proximal pins exited above the metaphyseal-diaphyseal junction (MDJ) region. Of these, 85.1% entered from lateral and posterior to the ossific nucleus of the capitellum (ONC). The pin angles averaged 58.4° and 90.5° in the coronal and sagittal planes respectively. In the second stage, 47 (65.3%) proximal pins in the intended group exited above the MDJ region, while only 32 (36%) in the random group exited above the MDJ region.
conclusionWhile aiming at the upper border of the distal MDJ during pinning, lateral pins can easily achieve a higher, proximal exit above the MDJ if inserted from lateral and posterior to the ONC and parallel to the humeral shaft in the sagittal plane. Higher exit can also be easily achieved in younger patients and patients fixated with smaller diameter pins.
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