Auditing the use of percutaneous pinning as a technique of fixation of unstable humeral supracondylar fractures in Sudanese children

Background: Supracondylar fractures of the humerus in children are commonly treated with closed reduction and percutaneous pin fixation. There has been controversy regarding the optimal pin configuration in the management of supracondylar humeral fractures in children. Objectives: To evaluate the effectiveness of closed percutaneous pinning (P.C.P.) as a treatment modality of supracondylar fractures of humerus in Sudanese children. Patients and methods: Hospital based prospective study conducted in Khartoum teaching hospital during the period from July 2006 to March 2007. It included all children less than 14 years of age, with closed type III supracondylar humeral fracture, extension variant, who treated by closed reduction and percutaneous cross pinning Results: 34 patients were included in the study. Their age ranged between 4-12 years, with mean +/- SD of 7.68 +/- 2.34 years. Twenty-four (70.6%) fractures were fixed with crossed pins whereas ten (29.4%) fractures with two lateral pins. The two lateral pins fixation was found to be significantly associated with loss of reduction (p=0.004). Conclusion: PCP is safe and effective with good functional outcome in treatment of unstable supracondylar fractures. The best wires configuration is that which gives ability to extend elbow with much stability.