Radial Head and Neck Fractures in Children

Steinberg, Ely L.; Golomb, Dor; Salama, R; Wientroub, Shlomo

doi:10.1097/01241398-198801000-00009

Cited by 108 publications

(89 citation statements)

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“…Angulation of more than 30°should be treated with closed reduction and immobilization for 3 weeks in a long-arm cast. Failure of closed reduction, however, requires operative intervention to reach an anatomic reduction and stabilization of the fracture [22,23]. Displaced sector frac- Preoperative X-ray of a radial neck fracture (Type Judet II) associated with a fracture of the lateral epicondyle of humerus immobilized in a long-arm cast prior to operative treatment (case 3).…”

Section: Discussionmentioning

confidence: 99%

“…It was mostly recommended that fractures in children up to 10 years of age with an angulation of the radius neck of more than 30°s hould be treated with closed reduction or less invasive manipulations [6,14,22]. Since open reduction with internal fixation often proved to result in poor outcome [4,23], various techniques of semi-closed reduction were demonstrated in children. Recently, a new technique of percutaneous reduction and internal fixation was described with an intramedullary wire being introduced from the distal part of the radius and projected upward in order to allow reduction by rotation of the proximal part of the bent wire [15].…”

Section: Introductionmentioning

confidence: 99%

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Minimally Invasive Technique for Reduction and Stabilization of Radial Head and Radial Neck Fractures in Children

Walcher

Rose

Mutschler

et al. 2000

European Journal of Trauma

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Integrity of soft tissues plays a major role in the final outcome of fractures of the proximal radius. Numerous minimally invasive operative techniques were developed to avoid additional trauma during surgical procedure. An overview over the literature is given in the present paper.We report a modified technique of Kapandji for percutaneous reduction and stabilization of displaced radial neck and radial head fractures in children. Functional results in 5 cases were good, and the children had no complaints. In one case with a luxation of the elbow and a fracture of the lateral epicondyle of humerus persistent rotation deficit was observed.The modified percutaneous method described here demonstrates an alternative procedure to reduce and stabilize displaced radial head and radial neck fractures. In contrast to open reduction this method avoids impairment of the anular ligament and joint capsule. Associated complex injuries of the elbow with soft tissue trauma, however, may lead to unsatisfactory functional results despite minimal operative technique and anatomic reduction.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Technique for Reduction and Stabilization of Radial Head and Radial Neck Fractures in Children

Walcher

Rose

Mutschler

et al. 2000

European Journal of Trauma

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“…Injuries necessitating open reduction and fixation tend to be more severe, and in one series, poor outcomes were noted in 50% of such cases, primarily as a result of avascular necrosis, radial head enlargement, and periarticular ossification. 11 Closed reduction in the presence of a radial neck fracture can result in an iatrogenic malposition of the radial head. Navali and Sadigi reported a 180u rotational malposition of the radial head where the articular surface was at the fracture site.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic radial neck fracture on closed reduction of elbow dislocation

Ellanti

O’Farrell

2013

CJEM

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Traumatic dislocation of the elbow is rare in children and can most often be managed in the emergency department using procedural sedation and closed reduction with good functional outcome. Radiographs must be evaluated for associated avulsions and fractures around the elbow. We present the case of a 14-year-old girl who sustained a fracture of the radial neck subsequent to repeated attempts at closed reduction of a pure posterior elbow dislocation that was missed on postreduction radiographs. Careful use of reduction techniques and avoidance of repeated forceful manipulations is emphasized. RÉ SUMÉLa dislocation traumatique du coude est rare chez les enfants; dans la plupart des cas, elle peut se traiter au service des urgences sous sé dation interventionnelle, par ré duction fermée, et la ré paration donne de bons ré sultats fonctionnels. Toutefois la recherche d'avulsions et de fractures possibles autour du coude, sur les radiographies, s'impose. Il sera question ici du cas d'une jeune fille de 14 ans, qui a subi une fracture du col du radius, à la suite de tentatives ré pé té es de ré duction fermé e d'une simple dislocation posté rieure du coude, qui est passé e inaperç ue sur les radiographies aprè s l'intervention. Aussi insisteronsnous sur l'application mé ticuleuse des techniques de ré duction et sur le fait d'é viter les manipulations é nergiques ré pé té es.

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“…We agree with both groups that grade-IV fractures require fixation after reduction to avoid redisplacement and repeated manoeuvres to achieve reduction which may compromise the blood supply to the neck. 7,16 We believe that CIMP is as easy and safe to perform as percutaneous pinning, but allows better positioning of the head of the radius. An important prognostic feature is the presence of associated injuries.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 Satisfactory reduction may not be achieved consistently, and because the K-wires are removed immediately after, dislocation can recur. 7,[14][15][16] Formal fixation of these fractures is preferable, and closed intramedullary pinning (CIMP), as proposed by González-Buendia et al 17 and Métaizeau et al, 7 combines non-invasive closed reduction with internal fixation fulfilling both requirements. We report our results obtained since November 1994 when we began to use CIMP instead of open reduction and transcondylar fixation.…”

mentioning

confidence: 99%