Supracondylar fractures of the humerus in children are commonly treated
with closed reduction and percutaneous pin fixation. Using an adult human
cadaver model, we measured the resistance to internal rotation of the
distal fragment of simulated supracondylar fractures, fixed with four
different configurations of pins. The maximum stability was provided by two
crossed pins placed from the medial and lateral condyles. In comparison,
the torque required to produce 10 degrees of rotation averaged 37 per cent
less with use of two lateral parallel pins and 80 per cent less with use of
two lateral crossed pins (p < 0.05 for both). The average torque
required to produce 10 degrees of rotation with use of three lateral pins
was 25 per cent less than with use of two medial and lateral crossed pins,
although the difference was not significant.