A Pediatric Supracondylar Fracture with Bilateral (Medial and Lateral) Pillar Comminution–A Recommendation for a New Stable Pin Configuration for a Highly Unstable Fracture

The management of supracondylar fractures in children remains a challenging area of orthopedic practice. Medial comminution is a recognized complication that can result in unstable fracture patterns, which can pose challenges in diagnosis and management. However, when anticipated surgical treatment with an additional medial K-wire is administered, stable fixation is typically ensured. However, an additional radial comminution poses several challenges for reduction, alignment assessment, and pin configuration for stable fixation, as presented in this case. This case report presents a fracture pattern of a Gartland type 3 fracture with medial and lateral comminution that has not been sufficiently described previously and illustrates an effective pin configuration that has yet to be theoretically described.