ArticleBMC musculoskeletal disorders2025
Ultrasound-guided cross-pin technique for paediatric supracondylar humerus fractures: minimizing iatrogenic ulnar nerve injury.
Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Non-rotational medial pinning with the K-Hammer technique in pediatric supracondylar fractures: a retrospective case-control study.Frontiers in pediatrics · 2026Article
- Iatrogenic Ulnar Nerve Injury Post-K-Wire Fixation of Supracondylar Humeral Fracture in a Child With Ulnar Nerve Instability: A Case Report and Review of the Literature.Case reports in orthopedics · 2026Article
- Clinical application of unilateral intramedullary K-wire occupying technique for flexible reduction in pediatric supracondylar humeral fractures.Frontiers in surgery · 2026Article
- Marked Increase in Anterior Ulnar Nerve Displacement at ≥90° of Elbow Flexion in Healthy Children.JB & JS open accessArticle
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Authors and funding
6 authors.
Funding
Abstract
backgroundPrevious ultrasound-guided cross-pin techniques, which employ 90° elbow flexion, have demonstrated effectiveness; however, they may be associated with an elevated risk of iatrogenic ulnar nerve subluxation or dislocation. The aim of this study was to evaluate the efficacy and safety of a modified ultrasound-guided cross-pin technique for reducing the risk of iatrogenic ulnar nerve injury in paediatric patients with supracondylar humerus fractures.
methodsThis retrospective study was conducted from December 2017- October 2019 and included paediatric patients with displaced supracondylar humerus fractures. The modified ultrasound-guided cross-pin technique was utilized to identify the ulnar nerve and confirm the medial pin position during pin placement with elbow in extension. The primary outcome measure was the incidence of iatrogenic ulnar nerve injury.
resultsA total of 145 patients (mean age 5.8 years) were enrolled. There were 103 children with Gartland type III fractures, 35 with type II fractures, and 7 with type IV fractures. The incidence of iatrogenic ulnar nerve injury was significantly reduced to 0%. A total of 12 cases had abnormal pin insertions, including 11 cases in which the proximity of the inserted medial pin to the ulnar nerve was close and 1 case in which the ulnar nerve was directly violated by the pin. The rate of pin misplacement was 8.3%. At the latest follow-up, all patients demonstrated excellent and good functional outcomes according to the Flynn criteria.
conclusionThe ultrasound-guided cross-pin technique may serve as a viable alternative for reducing the risk of iatrogenic ulnar nerve injury in paediatric patients with supracondylar humerus fractures.
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