LAUSR

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.