Does the configuration of the K-Wires in the coronal plane affect the time to union in supracondylar humerus fractures?

Aim: Supracondylar humerus fractures (SHF) are among the most common bone fractures in the pediatric population. However, there is no consensus in the literature regarding the configuration of the K wires used in this method. Materials and Methods: Patients who underwent closed reduction using two lateral and one medial percutaneous pins for SHF were included in the study. Measurements were made on the antero-posterior elbow radiographs of the patients taken on post-operative day 0. These measurements involved the angles of each K-wire with one another, the angles of the K-wires with the fracture line, and the angles between the K-wires and the humeral shaft. Postoperative complications, splint removal and pin removal times of all patients were recorded. Results: A total of 167 patients were included in the study. Uneventful fracture healing was achieved in all remaining patients. No significant relationship or correlation was found between the above-mentioned angular parameters and fracture union time. However, the angle between the pins placed laterally, the angle between the medial pin, and lateral pin 2, and the angle between lateral pin 2 and the humeral shaft were found to be larger in patients with complications than in patients without complications (p=0.0001, p=0.017, p=0.0001). Conclusion: The quality of fracture reduction is the basis for postoperative functional recovery. The results of this study that the main parameter affecting union in SHF is not the configuration of the pins in the coronal plane, but the anatomical fracture reduction and stable fixation obtained.