001 and p = 0.010) and residual displacement (p = 0.022). The cast and padding index did not differ significantly between groups (p = 0.77 and 0.15 respectively). Conclusions Cast and padding index did not correlate well as predictor of alignment loss, although in this study cortical stability seemed more important towards predicting alignment loss. © 2019 Delhi Orthopedic Association. All rights reserved.Objective Supracondylar humerus (SCH) fractures represent one of the most commonly treated fractures. We sought to determine 1) how often SCH fractures are associated with vascular injury; 2) mechanism of injuries; 3) where cases are treated 4) time to operating room (OR); and 5) length of stay (LOS). Methods The 2007-2014 National Trauma Data Bank (NTDB) data were analyzed for all patients less then 18 years of age who presented with an isolated supracondylar humerus fracture, with or without an associated vascular injury. Both non-operative and operative management were included. Main outcome measures were demographics, mechanism of injury, presence of vascular injury, time to OR, number of OR procedures, type of treating facility, and LOS. Comparisons were performed using Chi square test for categorical variables and Student's t-test for continuous variables. Results We identified a total of 53,571 pediatric patients over eight years with SCH fractures. Vascular injuries occurred in 149 patients (0.3%), which were significantly more common with open fractures (p  less then  0.001). Patients with vascular injuries had significantly longer LOS (3.5 days v 1.4 days; p  less then  0.001) and shorter times to the OR (4.7 h v 10.4 h; p  less then  0.001), and were more likely to be treated in teaching hospitals and pediatric level 1 trauma centers (p = 0.037). Conclusion The percentage of vascular injuries associated with SCH fractures in pediatric patients remains low (0.3%). The majority of pediatric patients with these injuries are treated at level 1 pediatric trauma centers. Level of evidence Therapeutic, III. © 2020 Delhi Orthopedic Association. All rights reserved.Introduction Supracondylar fracture of humerus (SFH) is frequently encountered in the immature skeleton, [1] predominantly in the non-dominant extremity. Aim This study compared the clinic-radiological outcome between cross pinning with lateral pinning for fixation of displaced supracondylar fracture of humerus in children. Materials and methods All eligible patients were randomized into two groups, group I for lateral pinning and group II for cross pinning. Before passing medial pin in group II a stab incision was given to visualise the medial epicondyle. Patients were followed up on 3 weeks, 6 weeks and 3 months. Final outcome was measured in terms of clinic-radiological union, Baumann angle, loss of reduction, stability of fracture fixation, incidence of iatrogenic nerve injury and Flynn's score. Results There were 37 patients in group I and 40 in group II. Both groups were comparable in terms of demographic details. At the final outcome there were no difference in between the groups in terms of all radiological and clinical outcome. Two patients of group I developed delay ulnar neuritis, which resolve completely in subsequent follow-up. Conclusion Both techniques provide stable fixation, union and good functional outcome without iatrogenic ulnar nerve injury provided that small incision sufficient enough to identify the medial epicondyle is given with passing of medial pin. © 2019 Delhi Orthopedic Association. All rights reserved.Background Fractures of lateral condyle of humerus are very common in children. While the management of acute displaced and rotated lateral condyle fracture of humerus with early open reduction and internal fixation yields good results, the results of late treatment are less clear. We conducted this study to analyse the results of operative treatment of late presenting fractures and see if it is dependent on the patient's age, fracture type, or the time until treatment. Materials & methods A retrospective study of 40 patients with a symptomatic lateral condyle fracture beyond 3 weeks, who underwent open reduction and internal fixation between January 2002 and December 2011, was conducted. Fractures were described as per Jakob's classification. Patients radiographs were evaluated, and clinical evaluation was done with Mayo elbow scoring and Dhillon scoring system as well as range of motion. Results Thirty-nine fractures united with average time of 7.8 weeks except one who had previous surgery done for the fracture and developed avascular necrosis. The average Mayo score was 93 and average Dhillon score was 7.6. The average improvement in the arc of motion was 40.32° (77.3-117.6°). Younger age and shorter time to operation had a statistically significant but weak effect on outcomes. Conclusions Functional outcomes of fractures managed surgically revealed good results, even in the fractures presenting more than 12 weeks after injury. Families with children presenting late should be offered ORIF to improve function and decrease symptoms. PIK-90 © 2019 Delhi Orthopedic Association. All rights reserved.Purpose The objective of this study was to evaluate the operative management of pes planovalgus deformity in ambulatory cerebral palsy (CP) children by calcaneal lengthening osteotomy described by Evans. Method Fifteen children (10 girls and 5 boys) with average age 11 years 6 months (range, 8 years 4 months-14 years 6 months) with 22 feet with pes planovalgus (PPV) deformity were included in this study. Clinical evaluation was made according to Dogan's scale and graded as perfect, good, fair and poor. Preoperative and postoperative radiological assessment of anteroposterior talo-first metatarsal angle (AP-T1MT), anteroposterior talo-calcaneal angle (AP-TC), laterl Talo-first metatarsal angle (Lat. T1MT), lateral Talo-calcaneal angle (Lat. TC), and lateral Calcaneal pitch angle (Lat. CP) had been done for all feet. All feet were corrected with the modification of the calcaneal lengthening osteotomy described by Mosca. Result Clinical results were perfect in 18 feet (82%), good in 2 feet (9%) and fair in 2 feet (9%).