الفهرس 
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Abstract
Children frequently sustain supracondylar humeral fractures, which account for 60% of all elbow-related fractures.. Two main types, extension type (98%) and flexion type (2%). (1)
The degree of displacement between the two fragments helps to classify supracondylar fractures.. This classification was originally proposed by Gartland and is still the most useful. Type I is a non-displaced , type II is angulated with and posterior cortex intact and type III is complete displacement with all continuity of the two fragments lost.
Pediatric S.C fractures of the humerus can be managed by using a variety of techniques such as closed reduction and casting, open reduction and internal fixation and closed reduction with percutaneous pinning.
If closed reduction and casting are selected, the cast must be applied with flexion of elbow at an angle > 120 degrees to preserve reduction. There is a great chance for vascular affection and reduction loss . So this technique is reserved for type I fractures.
Displaced supracondylar fractures (types II and III) should be treated with closed reduction and percutaneous pinning, either two lateral , one lateral and one medial pin or one transolecranon and one lateral pin(our study) may be used .
ORIF is reserved for displaced fracture not reduced by closed means, vascular injury needs exploration of the brachial artery and compound fractures. Cast immobilisation is unsafe because of the small risk of compartment syndrome and loss of reduction with cubitus varus deformity, whereas closed reduction and percutaneous pinning are safe. In comparison to ORIF, closed reduction and percutaneous pinning reduces the risk of elbow stiffness and is more economical because suture material is not used, prophylactic antibiotics are used for a shorter period , and the hospital stay is short.
In this study 30 child suffered from S.C fracture of the humerus were treated CRIF with transolecranon and Lat Kirschner wires. The mean age was 5yrs 8 months ranged from (3-12), 16 patients males (53.3%) and 14 patients females (46.7),Mechanism of injury FOOH in 23 patients (76.7%) and FFH in 7 patients (23.3%), the time from injury to surgery range (12-48) hours, Gartland classification 12 cases type II (40%), 18 type III (60%), the duration of follow up was 6months average.
According to Flynn’s system , 25 cases had excellent results , 3 had good results ,2 had fair results . they rapidly mobilized after removal of wires (3 - 4) weeks.