Finite element analysis of pin configurations used for paediatric supracondylar humeral fractures in an adult humerus model: evaluation of a condylo-trochlear sulcus technique.

PURPOSE: To compare the biomechanical performance of a configuration of two lateral pins and one condylo-trochlear sulcus pin (L2C1) with that of established pinning techniques using finite element analysis. METHODS: A simplified transverse distal humeral fracture model was created from quantitative computed tomography data of both humeri of a single healthy adult volunteer. Five lateral-entry and crossed pin configurations, including L2C1, were analyzed under flexion, extension, varus, valgus, internal rotation, and external rotation. RESULTS: L2C1 showed the greatest fixation stability under extension, varus, and valgus loading. Under rotational loading, crossed pinning demonstrated the greatest fixation stability, whereas L2C1 showed stability comparable to lateral three-pin fixation. CONCLUSIONS: In this adult humerus-based finite element model, the L2C1 configuration showed favourable fixation stability under extension, varus, and valgus loading compared with conventional lateral-entry pinning. Further anatomical, experimental, and clinical validation is required before extrapolation to paediatric supracondylar humeral fractures and clinical use.