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Multidirectionally Unstable Supracondylar Humeral Fractures in Children

Sharma, Anmol, MS1; Sethi, Anisha, MD1

doi: 10.2106/JBJS.RVW.18.00045
Review Articles

  • » Type-IV supracondylar humeral fracture is a rare pattern that presents with severe instability in both flexion and extension.
  • » These fractures cause considerable difficulty in the achievement and maintenance of reduction by means of pinning with use of closed methods and may result in malalignment and a poor outcome.
  • » Various authors have recommended their own modifications of Kirschner-wiring techniques for the treatment of these fractures.
  • » Four studies focusing on the treatment of this fracture, including a total of 56 type-IV supracondylar humeral fractures and 406 type-III fractures (controls), were identified.
  • » Because of its highly unstable nature, this type of fracture poses great difficulty in achieving and maintaining reduction with use of Kirschner wires and therefore requires special techniques.
  • » Regardless of the technique used, the outcome of type-IV fractures appears to be similar to that of type-III fractures once a stable reduction is achieved.

1Government Medical College and Hospital, Chandigarh, India

E-mail address for A. Sharma:

Investigation performed at the Government Medical College and Hospital, Chandigarh, India

Disclosure: No external funds were received in support of this study. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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