Loss of Fixation of a Type IV Supracondylar Humerus Fracture Treated with Three Divergent Lateral Pins Quality Improvement Case Series

Abstract

Supracondylar humerus fractures are common injuries encountered by orthopaedic surgeons.  Closed reduction and percutaneous pin fixation is classically considered the standard of care treatment for these injuries, as this treatment method minimizes trauma to the soft tissues, are associated with few complications, and have a high rate of success.  However, loss of fixation, when occurring, can lead to devastating cosmetic, functional, and neurological complications.  We present a case study of a displaced supracondylar humerus fracture initially treated with three lateral divergent pins that lost fixation and underwent subsequent surgical revision. We examine potential reasons for loss of fixation and keys to a successful surgical revision.