الفهرس 
REVIEW OFLITERATUREOnly 14 pages are availabe for public view
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Abstract
Supracondylar humeral fracture is a very common pediatric trauma disorder. It is very common between four and eleven years, more in boys than girls and left side affected more than right one. .
Major cases are extension type, which is sub classified according to Garteland classification by severity diagnosed radiologically through plain x-rays. Displaced fractures usually need fixation to avoid functional and cosmetic complications.
Operative treatment of Garteland type III usually included closed pinning by either lateral pins or crossed medial and lateral which is debatable what technique is preferable.
Crossed pinning is thought to be biomechanically more stable than lateral pinning especially if medial comminution present, but other authors thought that it is the same when putting in consideration diameter of wire, purchase of fracture fragment, divergence and gab at fracture site to include lateral and medial columns.
Ulnar nerve injury also is considered more risky during crossed pinning while other authors noted that least risk by mini incision and application of medial wire under vision.
Lateral pinning is still the safest according to iatrogenic ulnar nerve injury and gives even the same results as crossed pinning, recommendations to do intraoperative testing for torsional stability after fixation by lateral pins and if not stable medial pin should be added under vision.