Surgical technique for supracondylar fracture of the humerus with percutaneous leverage pinning.

Percutaneous pinning with a leverage technique for supracondylar fracture of the humerus was performed in 36 elbows in 35 children. The patient was placed in the lateral position with the forearm hanging. Under radiographic imaging, a Kirschner wire, as a reduction pin, was inserted into the fracture line from the dorsal side, passed through the posterior cortex of the proximal fragment, and turned distally. After reduction of the posterior displacement by the leverage technique, the reduction pin was driven into the anterior cortex of the proximal fragment. Subsequently, a Kirschner wire was inserted from the lateral condyle for fixation between the proximal and distal fragments. This percutaneous pinning technique was successfully performed in 32 of 36 elbows, with excellent functional results in 28 elbows and good results in 4, as well as excellent cosmetic results in 27 elbows and good results in 5, based on the evaluation criteria of Flynn et al.