{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T12:09:15Z","timestamp":1767182955574,"version":"3.41.0"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>Current literature on pin migration is inconsistent and its significance is not understood. We aimed to investigate the incidence, magnitude, predictors, and consequences of radiographic pin migration after pediatric supracondylar humeral fractures (SCHF). We retrospectively reviewed pediatric patients treated with reduction and pinning of SCHF at our institution. Baseline and clinical data were collected. Pin migration was assessed by measuring the change in distance between pin tip and humeral cortex on sequential radiographs. Factors associated with pin migration and loss of reduction (LOR) were assessed. Six hundred forty-eight patients and 1506 pins were included; 21%, 5%, and 1% of patients had pin migration \u22655\u2009mm, \u226510\u2009mm, and \u226520\u2009mm respectively. Mean migration in symptomatic patients was 20\u2009mm compared to a migration of 5\u2009mm in all patients with non-negligible migration (<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009&lt;\u20090.001). Pin migration\u2009&gt;\u200910\u2009mm was strongly associated with LOR [odds ratio (OR)\u2009=\u20096.91; confidence interval (CI), 2.70\u201317.68]. Factors associated with increased migration included increased days to pin removal (<jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\u2009=\u20090.022; CI, 0.002\u20130.043), migration outwards versus inwards (\u2009=\u20091.02; CI, 0.21\u20131.80), and BMI\u2009&gt;\u200995th percentile (OR\u2009=\u20091.63; [1.06\u20132.50]). Factors not associated with migration included cross-pinning, number of pins, and fracture grade. In summary, we identified a 5% incidence of radiographic pin migration\u2009\u2265\u200910\u2009mm and determined the factors associated with it. Pin migration became radiographically significant at &gt;10\u2009mm where it was strongly associated with LOR. Our findings contribute to the understanding of pin migration and suggest that interventions targeting pin migration may decrease the risk of LOR. Level of Evidence: Level III \u2013 Retrospective Cohort Study<\/jats:p>","DOI":"10.1097\/bpb.0000000000001069","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T12:00:05Z","timestamp":1678363205000},"page":"575-582","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Incidence, risk factors, and consequences of radiographic pin migration after pinning of pediatric supracondylar humeral fractures"],"prefix":"10.1097","volume":"32","author":[{"given":"Daniel","family":"Badin","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mickael","family":"Boustany","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Jay","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranjit","family":"Varghese","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul D.","family":"Sponseller","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2023,3,7]]},"reference":[{"key":"R1-20250526","doi-asserted-by":"crossref","first-page":"2287","DOI":"10.1007\/s00264-015-2975-4","article-title":"Supracondylar humeral fractures in children: current concepts for management and prognosis.","volume":"39","author":"Zorrilla","year":"2015","journal-title":"Int Orthop"},{"key":"R2-20250526","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/bpo.0b013e3180316cf1","article-title":"A systematic review of medial and lateral entry pinning versus lateral entry pinning for supracondylar fractures of the humerus.","volume":"27","author":"Brauer","year":"2007","journal-title":"J Pediatr Orthop"},{"key":"R3-20250526","doi-asserted-by":"crossref","first-page":"494","DOI":"10.2106\/JBJS.N.00758","article-title":"Pediatric distal humeral fractures and complications of treatment in Finland: a review of compensation claims from 1990 through 2010.","volume":"97","author":"Vallila","year":"2015","journal-title":"J Bone Joint Surg Am"},{"key":"R4-20250526","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1097\/BPO.0b013e31824b2b37","article-title":"Postoperative radiographs after pinning of supracondylar humerus fractures: are they necessary?","volume":"32","author":"Karamitopoulos","year":"2012","journal-title":"J Pediatr Orthop"},{"key":"R5-20250526","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1097\/BPO.0b013e3181b768ac","article-title":"Complications after pinning of supracondylar distal humerus fractures.","volume":"29","author":"Bashyal","year":"2009","journal-title":"J Pediatr Orthop"},{"key":"R6-20250526","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1097\/01241398-200411000-00002","article-title":"Complications and timing of follow-up after closed reduction and percutaneous pinning of supracondylar humerus fractures: follow-up after percutaneous pinning of supracondylar humerus fractures.","volume":"24","author":"Ponce","year":"2004","journal-title":"J Pediatr Orthop"},{"key":"R7-20250526","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1097\/01241398-200207000-00005","article-title":"Displaced pediatric supracondylar humerus fractures: biomechanical analysis of percutaneous pinning techniques.","volume":"22","author":"Lee","year":"2002","journal-title":"J Pediatr Orthop"},{"key":"R8-20250526","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/BPO.0b013e318242a99a","article-title":"Biomechanical analysis of supracondylar humerus fracture pinning for fractures with coronal lateral obliquity.","volume":"32","author":"Feng","year":"2012","journal-title":"J Pediatr Orthop"},{"key":"R10-20250526","first-page":"145","article-title":"Management of supracondylar fractures of the humerus in children.","volume":"109","author":"Gartland","year":"1959","journal-title":"Surg Gynecol Obstet"},{"key":"R11-20250526","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1007\/s00264-009-0787-0","article-title":"Inter- and intra-observer reliability of the Baumann angle of the humerus in children with supracondylar humeral fractures.","volume":"34","author":"Silva","year":"2010","journal-title":"Int Orthop"},{"key":"R12-20250526","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.1016\/j.injury.2016.06.037","article-title":"Clinical significance of anterior humeral line in supracondylar humeral fractures in children.","volume":"47","author":"Kao","year":"2016","journal-title":"Injury"},{"key":"R13-20250526","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/BPB.0000000000000636","article-title":"Fracture obliquity is a predictor for loss of reduction in supracondylar humeral fractures in older children.","volume":"29","author":"Segal","year":"2020","journal-title":"J Pediatr Orthop B"},{"key":"R14-20250526","doi-asserted-by":"crossref","first-page":"702","DOI":"10.2106\/00004623-200404000-00006","article-title":"Lateral-entry pin fixation in the management of supracondylar fractures in children.","volume":"86","author":"Skaggs","year":"2004","journal-title":"J Bone Joint Surg Am"},{"key":"R15-20250526","doi-asserted-by":"crossref","first-page":"735","DOI":"10.2106\/00004623-200105000-00013","article-title":"Operative treatment of supracondylar fractures of the humerus in children. 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