# A Pediatric Supracondylar Fracture with Bilateral (Medial and Lateral) Pillar Comminution–A Recommendation for a New Stable Pin Configuration for a Highly Unstable Fracture

## TL;DR

This paper presents a rare pediatric elbow fracture case with both medial and lateral bone damage and suggests a new pin placement method for better stability.

## Contribution

The paper introduces a novel pin configuration for a highly unstable fracture pattern not previously described.

## Key findings

- A Gartland type 3 fracture with medial and lateral comminution was identified as a unique and unstable pattern.
- A new pin configuration was found to provide stable fixation in this complex fracture type.
- The proposed method addresses challenges in reduction and alignment for such fractures.

## Abstract

The management of supracondylar fractures in children remains a challenging area of orthopedic practice. Medial comminution is a recognized complication that can result in unstable fracture patterns, which can pose challenges in diagnosis and management. However, when anticipated surgical treatment with an additional medial K-wire is administered, stable fixation is typically ensured. However, an additional radial comminution poses several challenges for reduction, alignment assessment, and pin configuration for stable fixation, as presented in this case. This case report presents a fracture pattern of a Gartland type 3 fracture with medial and lateral comminution that has not been sufficiently described previously and illustrates an effective pin configuration that has yet to be theoretically described.