Analysis of the outcome of cross K-Wire fixation and lateral K-Wire fixation in displaced supracondylar fracture of Humerus in children: A prospective comparative study

Background: Supracondylar humerus fractures (SHF) are among the most common fractures in children, often requiring surgical intervention for displaced fractures. Various pin fixation techniques, including cross pinning and lateral pinning, are commonly used to maintain reduction. The preferable method fixation remains debated considering the complications and the biomechanical stability of fixation. Objective: This study aims to compare the outcomes of two K-wire fixation techniques—cross pinning and lateral pinning—in paediatric patients with displaced supracondylar humerus fractures. Methods: An institution-based prospective study was conducted at Medical College and Hospitals, Kolkata, over 18 months (January 2021 to June 2022). Thirty paediatric patients under 18 years with displaced supracondylar humerus fractures were recruited. Fifteen patients were treated with cross K-wire fixation, while 15 received lateral K-wire fixation. Clinical and radiological outcomes, including range of motion, ulnar nerve palsy, fracture reduction stability, and Baumann’s angle, were assessed at 3 weeks, 6 weeks, 3 months, and 6 months postoperatively. Results: Out of 30 patients, 26 showed satisfactory results according to Flynn’s criteria. No loss of reduction occurred in either group. However, more patients in the lateral pinning group experienced mild loss of flexion (4 to 7 degrees). Three patients in the cross pinning group had partial ulnar nerve injuries, which fully recovered within 3 weeks. No nerve injuries were noted in the lateral pinning group. Conclusion: Cross pinning offers greater stability for displaced supracondylar humerus fractures but carries a risk of ulnar nerve injury. Lateral pinning provides comparable stability and is a safer option to avoid nerve injury. Both techniques are effective in maintaining reduction, but lateral pinning may be preferred in cases where nerve injury is a concern.