2019, Vol. 3 Issue 2, Part B
Supracondylar fracture of humerus in children is one of the most common fractures seen in Orthopaedic department all over the world accounting for 50 – 70% of all elbow fractures in children in the first decade of life 
. Traditionally this type of fracture is associated with high rates of malunion, nerve injury and vascular complications. Cross pinning has been presumed to be more stable but it can cause iatrogenic ulnar nerve injuries. Therefore this study was conducted to compare whether lateral pin construct if placed properly can provide the same stability like medial and lateral pinning, at the same time avoiding the possibility of iatrogenic ulnar nerve injury.
Aims and Objectives: To evaluate whether lateral pin fixation provides the same functional outcome compared to medial and lateral pin fixation and to assess whether chances of iatrogenic ulnar nerve injury was more in medial and lateral pin fixation than lateral pin fixation alone.
Materials and methods: All patients between 3 – 12 of age who had sustained Type III Gartland supracondylar humeral fractures who satisfied the inclusion criteria coming to Orthopaedics OPD/casualty were assessed both clinically and radiologically. Patients were randomly selected by drawing lots with even numbers included in Group A (lateral entry) and odd number in Group B (medial and lateral entry). In all cases a posterior approach and triceps splitting method was used. A neurovascular examination was done preoperatively and in the immediate post-operative period. All the patients were evaluated clinically and radiologically in the immediate post operative period followed by examination at 1 week, 4 weeks, 3 months and 6 months. The final grading was decided by putting the values of the three parameters considered in the Modified Flynn’s Criteria in the final scoring system
Results and discussion: In this study in group A 21 patients had Excellent, 6 patients had Good, 3 patients Fair and one patient had Poor results. In group B 20 patients had Excellent, 5 patients Good, 3 patients Fair and one patient had Poor outcomes. The results of this study were comparable to a similar study done by Yi Meng Yen and Mininder S Kocher  although the study used closed reduction and percutaneous pinning as the procedure.
Conclusions: From this prospective study we conclude that there is no significant difference between the stability and functional outcome provided by the medial and lateral pin fixation and two lateral pin fixation methods. But the medial and lateral pinning group shows one case of iatrogenic ulnar nerve injury. Therefore, the lateral pin fixation method for the treatment of Type III supracondylar fractures of humerus in children is a reliably safe method to avoid iatrogenic ulnar nerve injury which also provides adequate stability if the proper pin fixation principles are used.