Sir,

The authors of the article in question [1] have made a good analysis of crossed pinning in paediatric supracondylar humerus fractures using a retrospective cohort. Results showed that according to Flynn’s criteria 73 patients (93.5 %) had a satisfactory outcome, while five (6.4 %) were graded as unsatisfactory (two due to cubitus varus and three because of limited elbow motion). The visual analogue scale (VAS) score averaged 0 (range 0–1) and the mean carrying angle measured 8.4° (−8 to 20°), compared to 10.8° on the contralateral side (2–20°).

There are two queries which come to mind related to the analysis of pain using VAS.

  1. 1.

    The authors have used a VAS scale of 0 to 10 to describe minimum and maximum severity of pain, respectively. In the results of their analysis the authors mentioned average VAS to be 0 with a range of 0 to 1. This means that a few of the patients might not have had pain at all (0) and a few patients had pain of score 1 or of less severity. Thus, average VAS score should be between 0 and 1 and not zero.

  1. 2.

    VAS score is a subjective evaluation of pain and it’s range can be constructed on a ten-point scale or 100-point scale [2]. To be more precise, in evaluation of pain a larger scale used will have less chance of error. We think if the authors had used a larger scale with 0 being no pain and 100 being extreme pain then more precise calculation of VAS could be obtained.

We agree with the rest of the criteria for evaluation and their results.