Evaluation of the stability of pin configuration in K-wire fixation of displaced supracondylar fractures in children.

Precutaneous Kirschner wire fixation of displaced Gartlands types II and III supracondylar fractures with image guidance remains a preferred procedure for most orthopaedic units. Various K-wire configurations have been in use, but recent objective evaluation of pin stability has favoured two techniques; the 2 crossed pins placed from the medial and lateral epicondyles, and 2 parallel lateral pins when the former technique is impracticable because of swelling. We reviewed patients who had K-wire fixation precutaneously over a 2-year period (Feb 1996 to Feb 1998). There were 44 children, 30 males, 14 females, ages between 1-15 years. 19 patients had (medial and lateral pins) 15, (2 parallel lateral) and 10 patients (2 lateral crossed) precutaneous pin placement respectively. Their postoperative course indicated that maximum stability was obtained with two opposite crossed pins, followed by the 2 paralleled pin method. These observation determined the choice of technique by the surgeons who operated on these patients.