Close Reduction Technique for Severely Displaced Radial Neck Fractures in Children

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Traumatology

Background:

• Radial neck fractures are a common pediatric elbow injury, accounting for 5-10% of cases.
• Judet classification categorizes these fractures into five types (I-IVb).
• Severely displaced fractures (Type III, IVa, IVb) typically require reduction, but current methods lack uniformity in achieving complete reduction.

Purpose of the Study:

• To present a case series on the experience with close reduction for severely displaced pediatric radial neck fractures (Judet Type IVa and IVb).
• To evaluate the efficacy of close reduction in achieving complete anatomical reduction and functional outcomes.

Main Methods:

• Ten consecutive children (average age 8.59 years) with severely displaced radial neck fractures (Judet Type IVa/IVb) underwent close reduction.
• All reductions were performed within 48 hours of injury.
• One patient had an associated undisplaced lateral condyle fracture; two with elbow dislocations were excluded.

Main Results:

• Complete anatomical reduction was achieved in all ten patients using the described close reduction technique.
• No patients required surgical fixation.
• At one-year follow-up, all patients demonstrated a near-full range of elbow and forearm motion with complete union and no avascular necrosis.

Conclusions:

• Close reduction is a viable and effective technique for managing severely displaced pediatric radial neck fractures (Judet Type IVa and IVb).
• This method provides an alternative to surgical intervention, achieving excellent anatomical and functional outcomes.