Outcomes of supracondylar humerus fractures treated with Dorgan’s pinning and extension casting at 150°: a retrospective cohort study of 112 children with 5-year follow-up

Abstract

Background: Objectives were to evaluate the long-term clinical and functional outcomes of the Dhavani Technique-a minimally invasive approach combining closed reduction, Dorgan’s lateral cross pinning, and 150° extension casting-in the management of paediatric supracondylar humerus fractures. Methods: A 10-year multicenter retrospective cohort study conducted across three tertiary care centres. Between 2015 and 2024, 112 children with closed supracondylar humerus fractures (75 Gartland type II and 37 type III) were treated using closed reduction followed by Dorgan’s lateral cross-pinning without incision and post-operative immobilisation with casting at 150° elbow extension. All procedures were performed within four days of injury. Patients were followed for a mean duration of five years. Outcome measures included operative time, neurovascular complications, pin site infections, plaster-related issues, residual deformity, physiotherapy requirement, and final functional range of motion. Results: No post-fixation neurovascular complications were observed. Operative time was notably shorter compared with traditional crossed pinning techniques. Superficial K-wire site infections occurred in seven cases (6.25%) and were managed conservatively. Plaster slippage occurred in nine cases; all successfully converted to full casting at two weeks without further issues. Cubitus varus developed in two patients (1.8%). Twenty-one children (18.75%) required physiotherapy for complete motion recovery. At final follow-up, all patients achieved full functional range of motion with no lasting functional limitations. Conclusions: The Dhavani Technique is a safe, reliable, and minimally invasive option that reduces operative time, avoids incisions, and provides excellent long-term functional and cosmetic outcomes.