Supracondylar fractures of the femur in children: closed reduction and percutaneous pinning of displaced fractures

The authors reviewed nine children with 10 displaced supracondylar femoral fractures that were treated by closed reduction and percutaneous pinning. The average age of the patients was 8.3 years (range 5-13). After removal of the pins and plaster at 5 weeks, full range of movement was regained within 3 weeks. At late follow-up (average 7.4 years range 4-10]), seven of the eight patients reviewed (nine fractures) had a satisfactory result. One patient had a valgus deformity of 6 degrees. There was no growth plate arrest and no leg length discrepancy. Intra-articular pin placement was avoided, considering the different synovial attachments on the medial and lateral sides. One patient developed a common peroneal nerve palsy, and therefore a cadaver study was performed to determine whether movement of the knee after pin placement affected the nerve. Although the lateral pin did tether the iliotibial band, the common peroneal nerve was not affected.