![]() ![]() passed obliquely through medial epicondyle, just proximal to olecranon fossa The posterior intrafocal pin improves sagittal alignment in Gartland type III paediatric supracondylar humeral fractures. Biomechanical Analysis of Posterior Intrafocal Pin Fixation for the Pediatric Supracondylar Humeral Fracture Treatment of Gartland Type III Pediatric Supracondylar Humerus Fractures with the Kapandji Technique in the Prone Position. ![]() Intraoperative Stability Testing of Lateral-Entry Pin Fixation of Pediatric Supracondylar Humeral Fractures A prospective randomised, controlled clinical trial comparing medial and lateral entry pinning with lateral entry pinning for percutaneous fixation of displaced extension type supracondylar fractures of the humerus in children. Three lateral divergent or parallel pin fixations for the treatment of displaced supracondylar humerus fractures in children. Lateral-Entry Pin Fixation in the Management of Supracondylar Fractures in Children. Biomechanical testing of pin configurations in supracondylar humeral fractures: the effect of medial column comminution. Biomechanical analysis of pin placement for pediatric supracondylar humerus fractures: does starting point, pin size, and number matter? Biomechanical Analysis of Supracondylar Humerus Fracture Pinning for Fractures With Coronal Lateral Obliquity Prevention of ulnar nerve injury during fixation of supracondylar frx by 'flexion-extension cross-pinning' technique. Loss of Pin Fixation in Displaced Supracondylar Humeral Fractures in Children: Causes and Prevention. Crossed Wires Versus 2 Lateral Wires in Management of Supracondylar Fracture of the Humerus in Children in the Hands of Junior Trainees. Cross pinning for supracondylar humerus fractures in children carries risk of iatrogenic ulnar nerve injuries 2 years after the pinning, one of the 17 children with ulnar nerve injury had persistent motor weakness and a sensory deficit medial pin was associated w/ ulnar n injury in 4% patients in whom the pin was applied w/o hyperflexion of the elbowĪnd in 15% in whom the medial pin was applied w/ elbow hyperflexed ulnar nerve injury was not seen in the 125 patients in whom only lateral pins were used configuration of the pins did not affect the maintenance of reduction of either type-2 fractures or type-3 fractures consider placing a temporary 2nd pin thru the lateral condyle to achieve even more stability insert lateral pin first to obtain stability while reduction is evaluated (avoids need to repeatedly insert medial pins if reduction is pin should avoid the olecranon fossa and should come to rest along the far cortex ![]() generally, the pin is aimed 35 deg upward and 10 deg posterior wire is inserted thru the capitellum, and then the distal humeral physis because the center of the capitellum is in line w/ anterior aspect of humeral shaft, the pin must be directed slightly posteriorly insertion point is in the center of lateral condyle (capitellum) Safe Zone for Superolateral Entry Pin Into the Distal Humerus in Children: An MRI Analysis avoid directing pins too far anterior or posterior w/ children younger than 5-6 years, use 0.062 smooth K wire pins need to be smooth w/ trochar point w/ posterolateral displacement, place arm in maximum internal rotaiton on the flourscopy platform, and insert the lateral pin first w/ posteromedial displacement, place arm in maximum external rotation on flourscopy platform, and insert the medial pin first pins should cross proximal to the frx at an angle of about 30 deg to the humeral shaft consider applying sterile "coband" to keep elbow flexed, which then allows arm to be externally rotated to achieve a lateral in preparing for crossed pinning, keep elbow hyperflexed to maintain reduction 2 lateral pins may not permit full elbow extension, thus preventing full assessment of carrying angle medial and lateral pin insertion provides better stabilization either two lateral pins, or one lateral and one medial pin may be used and both should penetrate the cortex has become standard technique for stabilizing types II & type III frx ![]()
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