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This study evaluates outcomes of a three-wire technique for treating irreducible ESCHF. Methods Twenty pediatric patients underwent closed reduction with percutaneous pinning using two distal K-wires and one proximal wire to correct sagittal, coronal, and rotational deformities. Results Favorable radiological outcomes were achieved, with mean operation time 32.65 min and mild pin tract infections resolving within one week after K-wire removal.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/three-wire-technique-for-irreducible-extension-type-supracondylar-humeral-fracture-in-children/458619/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/three-wire-technique-for-irreducible-extension-type-supracondylar-humeral-fracture-in-children/458619.png","ImageObject",300,407,{"name":92,"@type":93},"Grenda","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-04","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What problem does the three-wire technique aim to solve in children with ESCHF?","Question",{"text":112,"@type":113},"It targets irreducible extension type supracondylar humeral fractures where acceptable alignment cannot be achieved or maintained after two closed reduction trials, potentially avoiding the risks of open reduction.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the three-wire technique performed in the study?",{"text":117,"@type":113},"Two K-wires were placed in the unreduced distal fragment and one proximal wire was inserted just above the olecranon fossa, then used to manipulate and correct sagittal, coronal, and rotational deformities.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main outcomes and complications reported?",{"text":121,"@type":113},"All fractures achieved acceptable closed reduction with mean operation time 32.65 min. Radiology showed favorable angles, and five patients had mild pin tract infections that resolved within one week after K-wire removal.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},458619,1791072894,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},7971474921005,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Badawy et al. Journal of Orthopaedic Surgery and Research (2026) 21:20  \n[https://doi.org/10.1186/s13018-025-06543-z](https://doi.org/10.1186/s13018-025-06543-z)  \nJournal of Orthopaedic Surgery and Research  \nRESEARCH Open Access  \nThree-wire technique for irreducible extension type Supracondylar humeral fracture in children  \nMahmoud Badawy 1*, Sami Ibrahim Sadek2, Mohammad Hassan3, Ahmed Mostafa El nagar2, Elsayed Shaheen4 and Ibrahim Abdellatif Algohiny2  \nAbstract  \nBackground Irreducible extension type supracondylar humeral fracture [ESCHF] accounts for 3–15% of cases and often requires open reduction, which carries the risk of complications. This study describes and reports the outcomes of the three-wire technique for treating irreducible ESCHF.  \nMethods Twenty patients with irreducible ESCHF (8 girls and 12 boys) underwent closed reduction and percutaneous pinning using the three-wire technique. We inserted two K-wires in an unreduced position in the distal fragment and one proximal wire just above the olecranon fossa and used these three wires for manipulation and correction of sagittal, coronal, and rotational deformities at the fracture site.  \nResults All the fractures achieved acceptable closed reduction, with a mean operation time of 32.65 min. Radiological assessments showed favorable outcomes: the mean Baumann angle was 70.05 ± 1.70 degrees, the average carrying angle was 12.95 degrees, and the anterior humeral line dissected the capitell um at the middle third in 16 patients and at the anterior third in 4 patients. The complications included mild pin tract infections in five patients, all of which resolved within one week after K-wire removal.  \nConclusion The three-wire technique is effective for managing irreducible ESCHF, providing good outcomes while avoiding the risks associated with open reduction.  \nKeywords Extension type supracondylar humeral fracture, Irreducible supracondylar humeral fracture, Closed reduction techniques for supracondylar humeral fracture  \n*Correspondence:  \nMahmoud Badawy  \n[mahmoudbadawy526@gmail.com](mahmoudbadawy526@gmail.com); [MEIsmail@medicine.zu.edu.eg](MEIsmail@medicine.zu.edu.eg)[ ](MEIsmail@medicine.zu.edu.eg)[1](1Zagazig University)[Zagazig University](1Zagazig University), Menia El-Qamh, Sharkia 44111, Egypt 2Zagazig University, Zagazi, Sharkia 7510001, Egypt  \n3Zagazig University, El Husseiniya, Sharkia 44654, Egypt 4Alazhar University, Cairo 3753450, Egypt  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/l](http://creativecommons.org/l)icenses/by/4.0/.  \nBadawy et al. Journal of Orthopaedic Surgery and Research (2026) 21:20 Page 2 of 10  \nIntroduction  \nExtension type supracondylar humeral fracture (ESCHF) accounts for approximately 97% of all supracondylar humeral fractures (SCHFs). Gartland classified these fractures into three types based on the degree of the displacement [2]. Leitch and coworkers [3] later added a type IV SCHF, which represents a multidirectional unstable fracture lacking a periosteal hinge.  \nMost displaced ESCHF patients are treated with closed reduction and percutaneous pinning. A minority of cases in which closed reduction fails require open reduct","cbCaiqoxBW2o7opq","https://ap.wps.com/l/cbCaiqoxBW2o7opq","pdf",1349217,"English","# Abstract\n# Introduction\n## Fracture background and classification\n## Closed reduction and pinning history\n## Definition and criteria for irreducible ESCHF\n## Complications and reduction failure rate","[{\"question\":\"What problem does the three-wire technique aim to solve in children with ESCHF?\",\"answer\":\"It targets irreducible extension type supracondylar humeral fractures where acceptable alignment cannot be achieved or maintained after two closed reduction trials, potentially avoiding the risks of open reduction.\"},{\"question\":\"How was the three-wire technique performed in the study?\",\"answer\":\"Two K-wires were placed in the unreduced distal fragment and one proximal wire was inserted just above the olecranon fossa, then used to manipulate and correct sagittal, coronal, and rotational deformities.\"},{\"question\":\"What were the main outcomes and complications reported?\",\"answer\":\"All fractures achieved acceptable closed reduction with mean operation time 32.65 min. Radiology showed favorable angles, and five patients had mild pin tract infections that resolved within one week after K-wire removal.\"}]","Three-wire technique for irreducible extension type Supracondylar humeral fracture in children | PDF",1790753866,25]