Supracondylar fracture of humerus is one of the common pediatric fractures encountered by an orthopedic surgeon. Closed reduction and percutaneous pinning is one of the recommended treatments for displaced-supracondylar fracture of humerus. The growth plate of distal humerus in the pediatric age group is a relatively small area and drilling Kirschner (K)-wires across the physes will cause physical, thermal, and vascular damage to it. It is a very common scenario where a K-wire is drilled multiple times to achieve acceptable position and the damage to the growth plate gets added with every new attempt and is further compounded as the number of K-wires required to achieve stability increases. Thus, we may achieve a good reduction and a stable fixation but still cause irreversible damage to the growth plate and end up with resultant deformity. We suggest a simple modification in the pinning technique by using a bone marrow aspiration needle to act as a guide and sleeve. This technique helps in reducing the number of attempts required to achieve acceptable position of the pins thereby reducing above-mentioned iatrogenic damage to the physes. It not only prevents soft tissue injury by acting as a sleeve but also gives mechanical advantage during passage of thin diameter K-wire in small children. It can also be used to find the proximity of ulnar nerve by stimulating it, thereby reducing the chance to damage the nerve during medial pinning.
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