Pediatric Olecranon Fractures Associated With Radial Neck Fractures: Review and Report of Two Cases

The debate regarding the description on classification and nomenclature of the injury which includes olecranon fracture associated with radial neck fractures in children is ongoing. We report two pediatric cases that could not be classified in a Monteggia-equivalents system and were treated with open reduction and k-wire fixation. The aim of this study was to perform a systematic review regarding pediatric radial neck fractures associated with olecranon fractures and presentation of two pediatric cases of olecranon fractures associated with radial neck fractures with radiocapitellar dislocation.

Two boys, aged 7 and 12, came to two separate clinics on the same day after initial injury. On physical examination, the patients' elbow range of motion was limited and painful. Their upper extremities were intact. Radiographs revealed the radial neck fracture with prominent anterolateral radiocapitellar dislocation of radial head-associated with non-displaced olecranon fracture. Radial neck fracture was reduced easily by pushing posteromedially manually with the finger and secured with two K-wires .The olecranon fracture was visualized and confirmed that it was non-displaced and secured with two k-wires in the first case and one k-wire in the second case. After 2 months of follow-up, both patients had no pain in their elbow and a full functionality with a full range of motion of the elbow. The posterior intraosseous nerve functions were normal.

The fracture of olecranon if it does not extend into the metaphyseal region; it could not fascilitate diastasis of the proximal radioulnar joint and radial head dislocation. So this type of fracture must not be addressed as a Monteggia-fracture dislocation. The description of radioulnar diastasis must be included when this type of injury is to be classified.