Pediatric Supracondylar Fractures: Are Medial Pins Indicated?

The most common elbow fractures that are seen in children are the supracondylar fractures of the humerus that can be managed by both operative and non-operative modalities [1]. Whether a supracondylar fracture can be managed operatively depends on fracture stability, the degree of displacement and the ability to control displacement through traction [2,3]. Operative management is managed initially with lateral pinning with further assessment of stabilization in order to determine if a medial pin is needed. Several studies have noted that cross pinning is biomechanically superior to lateral pinning [4,5]. The drawback with cross pinning is potential iatrogenic ulnar nerve injury [6,7].