A systematic review of medial and lateral entry pinning versus lateral entry pinning for supracondylar fractures of the humerus,

摘要

Context: More than 200 articles have been published on supracondylar fractures of the humerus during the past 10 years. This systematic review carefully examines the literature, summarizing the results of 68 reports of more than 2000 children regarding the outcomes comparing two techniques of closed reduction and pinning of these fractures.Study Design, Results, and Conclusions: All randomized trials (two), prospective (six) and retrospective (27) cohort studies between 1996 and 2004 of displaced supracondylar humerus fractures treated with two medial and lateral crossed or two lateral pins, were compared for iatrogenic nerve injury, deformity and/or loss of reduction. The technique of medial and lateral pin entry had a statistically higher probability of any iatrogenic nerve injury (1.8 times, 3.5 vs. 1.9%) than lateral-only pin entry, and a five times greater risk of ulnar nerve injury (3.4% vs. 0.7%). Medial and lateral cross pin entry was found to have 0.58 times the risk of deformity or loss of reduction, significantly less than the lateral entry pinning group.