Intramedullary elastic nailing of the displaced radial neck fractures in children

Objective: The aim of this study was to report the clinical and radiological results of 11 patients withJudet type 3 severely displaced radial neck fractures, who were treated with intramedullary elastic nailŞxation with the help of percutaneous K-wire reduction maneuver (M etaizeau technique).Methods: A total of 11 children (4 boys and 7 girls with a mean age of 7.7 (6e10) years) with Judet type 3radial neck fractures were treated in our clinic between February 2013 and August 2015. The fractureswere evaluated according to Judet classiŞcation system modiŞed by Metaizeau. Reduction andŞxationwas performed within theŞrst 24 h after injury in all patients. All fractures were treated by closedreduction using distal elastic intramedullary nail. Clinical evaluation was performed by measuring elbowrange of motion (ROM) with goniometer, radiological evaluation by assessing fracture healing andfunctional evaluation by using Mayo Elbow Performance Score (MEPS).Results: The mean MEPS score increased from 15 points preoperatively to 88 points postoperatively(range, 12e95 points). Radiological evaluation revealed that all fractures healed with excellent or goodalignment. The meanflexion was 150(range, 145e154), extension 1(range, 0e2), supination 82(range, 80e86), and pronation 83(range, 80e85).Conclusion: Reduction and osteosynthesis of radial neck fractures by intramedullary nailing with thehelp of percutaneous K-wire manipulation appears to be a simple, safe and effective treatment method inchildren.Level of evidence: Level IV, Therapeutic study.

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1. Prathapkumar KR, Garg NK, Bruce CE. Elastic stable intramedullary nail fixation for severely displaced fractures of the neck of the radius in children. J Bone Jt Surg Br. 2006 Mar;88(3):358e361.

2. Gagliardi Ida C, Mouraria GG, Funayama B, Kikuta FK, Cruz MA, Zoppi A. Evaluation of children with radial neck fractures treated with flexible intramedullary nail. Acta Ortop Bras. 2016 MareApr;24(2):81e84.

3. Ugutmen E, Ozkan K, Ozkan FU, Eceviz E, Altintas F, Unay K. Reduction and fixation of radius neck fractures in children with intramedullary pin. J Pediatr Orthop B. 2010 July;19(4):289e293.

4. Ursei M, Sales de Gauzy J, Knorr J, Abid A, Darodes P, Cahuzac JP. Surgical treatment of radial neck fractures in children by intramedullary pinning. Acta Orthop Belg. 2006 Apr;72(2):131e137.

5. Tarallo L, Mugnai R, Fiacchi F, Capra F, Catani F. Management of displaced radial neck fractures in children: percutaneous pinning vs. elastic stable intramedullary nailing. J Orthop Traumatol. 2013 Dec;14(4):291e297.

6. Steele JA, Graham HK. Angulated radial neck fractures in children. A prospective study of percutaneous reduction. J Bone Jt Surg Br. 1992 Sep;74(5): 760e764.

7. Metaizeau JP. Reduction and osteosynthesis of radial neck fractures in children by centromedullary pinning. Injury. 2005 February;36(suppl 1):75e77.

8. Metaizeau JP, Lascombes P, Lemelle JL, Finlayson D, Prevot J. Reduction and fixation of displaced radial neck fractures by closed intramedullary pinning. J Pediatr Orthop. 1993 MayeJun;13(3):355e360.

9. Judet J, Judet R, Lefranc J. Fracture of the radial head in the child. Ann Chir. 1962 Sep;16:1377e1385.

10. Judet H, Judet J. Fra ctures and orthopedique de l' enfant. Paris: Maloine; 1974: 31e39.

11. Morrey BF, An KN, Chao EYS. Functional evaluation of the elbow. In: Morrey BF, ed. The Elbow and Its Disorders. 2nd ed. Philadelphia: WB Saunders; 1993: 86e89.

12. Pring ME. Pediatric radial neck fractures: when and how to fix. J Pediatr Orthop. 2012 Jun;32(suppl 1):14e21.

13. Schmittenbecher PP, Haevernick B, Herold A, Knorr P, Schmid E. Treatment decision, method of osteosynthesis, and outcome in radial neck fractures in children: a multicenter study. J Pediatr Orthop. 2005 JaneFeb;25(1):45e50.

14. Pring ME, Wenger DR, Rang M. Elbowdproximal radius and ulna. In: Rang M, Pring ME, Wenger DR, eds. Rang's Children's Fractures. Philadelphia: Lippincott Williams & Wilkins; 2005:119e134.

15. Vocke AK, Von Laer L. Displaced fractures of the radial neck in children: longterm results and prognosis of conservative treatment. J Pediatr Orthop B. 1998 July;7(3):217e222.

16. Al-Aubaidi Z, Pedersen NW, Nielsen KD. Radial neck fractures in children treated with the centromedullary Metaizeau technique. Injury. 2012 Mar;43(3):301e305.

17. Cossio A, Cazzaniga C, Gridavilla G, Gallone D, Zatti G. Paediatric radial neck fractures: one-step percutaneous reduction and fixation. Injury. 2014 Dec;45(suppl 6):80e84.

18. Radomisli TE, Rosen AL. Controversies regarding radial neck fractures in children. Clin Orthop. 1998 August;353:30e39.

19. Okcu G, Aktuglu K. Surgical treatment of displaced radial neck fractures in children with Metaizeau technique. Ulus Travma Acil Cerrahi Derg. 2007 April;13(2):122e127.

20. Tan BH, Mahadev A. Radial neck fractures in children. J Orthop Surg (Hong Kong). 2011 Aug;19(2):209e212.

21. Zhang FY, Wang XD, Zhen YF, Guo ZX, Dai J, Zhu LQ. Treatment of severely displaced radial neck fractures in children with percutaneous K-wire leverage and closed intramedullary pinning. Medicine (Baltimore). 2016 Jan;95(1):2346.
Acta Orthopaedica et Traumatologica Turcica-Cover
  • ISSN: 1017-995X
  • Başlangıç: 2015
  • Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
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