Functional outcome of displaced radial head fractures in children treated by elastic stable intramedullary nailing

Abstract

The objectives of this study were to retrospectively investigate the clinical and radiological outcomes of displaced radial head fractures in children treated by elastic stable intramedullary nailing (ESIN) and evaluate the functional outcome of these injuries using the short version of the Disabilities of the Arm, Shoulder and Hand outcome questionnaire (Quick DASH). A total of 24 patients (nine males and 15 females) fulfilled the inclusion criteria. The mean age at the time of injury was 10.7±2.8 years (range: 9.5-16.33 years). Before surgery, the mean angulation was 53.8°±18.4° (range: 28°-82°) differentiating fractures on the basis of Judet's classification. The mean Quick DASH score was a good 4 (range: 0-15.9). Functional outcomes were similar irrespective of the severity of fracture displacement (P>0.05), presence or absence of associated fracture (P>0.05), and time immobilized (P>0.05). The Quick DASH score was better in children younger than 9 years of age (1.62) than children older than 9 years of age (4.95), but without a statistically significant difference (P=0.058). Children with displaced radial head fractures treated with ESIN showed good functional outcomes. Associated fracture injuries were not a predictive factor of functional outcome. Open reduction must be avoided as it carries an increased risk of complications.

Treatment strategy and long-term functional outcome of traumatic elbow dislocation in childhood: A single centre study

“…The QuickDASH score, which comprises 11 questions, represents an abbreviated version of the DASH outcome measure score. 38 In accordance with Guyonnet et al 39 we noted that all our patients were able to answer the questions of the QuickDASH questionnaire together with their families without any significant problems.…”

“…The functional outcome of fractures of the medial epicondyle or condyle in children assessed with the QuickDASH score compares well with the results obtained in a cohort of children who sustained fractures of the radial neck treated by elastic stable intramedullary nails. 39 This finding indicates the benign nature of elbow fractures in children.…”

The use of external fixation for the management of acute and chronic Monteggia fractures in children

“…Wang et al 23 applied it to children treated surgically for supracondylar humerus fractures. Guyonnet et al 24 used it in children with radial head fractures treated by elastic stable intramedullary nails and Corradin et al 25 used it in children with isolated olecranon fractures treated surgically.…”

“…The Quick DASH score ranges from 0 (least disability) to 100 points (most disability) and allows evaluation of the overall performance of the upper limb. 20-24…”

“…20 The Quick DASH questionnaire has been successfully used to evaluate functional outcomes after surgical treatment of various upper extremity fractures in children, and it allows for homogeneous evaluation and comparison of varied paediatric patient populations. [21][22][23][24][25] The main objective of this study was to retrospectively evaluate the clinical and radiological outcomes of AMF and CMF in children treated by closed or open reduction and EF. The secondary aim was to evaluate upper extremity function with the Quick DASH.…”