compared outcomes after percutaneous pinning versus open reduction in paediatric supracondylar elbow fractures background supracondylar fractures of the elbow are common in children their treatment is controversial when displacement has occurred although percutaneous pinning is usually advocatedhypothesis in paediatric extensiontype supracondylar fractures of the elbow percutaneous pinning and crossed kwire fixation after open reduction via the medial approach produce similar functional outcomes and complication ratesmaterials and methods we retrospectively reviewed the medical charts of 58 children aged 2 to 15 years who underwent surgery for extensiontype supracondylar elbow fractures between 2004 and 2008 closed reduction and percutaneous pinning was used in 33 patients with a mean age of 7 years and 11 months open reduction with crosswiring in 25 patients with a mean age of 7 years functional outcomes were assessed using flynns criteria baumanns angle was determined and postoperative complications and sequelae were recordedresults outcomes were satisfactory in 30 909 patients treated with percutaneous pinning and in 23 92 patients treated with open reduction and crosswiring mean baumanns angle at last followup was 739574 after percutaneous pinning and 7476407 after open reduction and crosswiring postoperative complications consisted of reoperation in six 103 patients and iatrogenic nerve injury in two 34 patients cubitus varus occurred in two 606 patients after closed treatment and in one 4 patient after open treatment in each group three 51 patients had greater than 15 of motion range limitationdiscussion in children with extensiontype supracondylar elbow fractures outcomes are similar with percutaneous pinning and with open reduction via the medial approach followed by crosswiringlevel of evidence level iv retrospective study