Percutaneous K-wire reduction and cast immobilization for severely displaced radial neck fractures in children

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Traumatology

Background:

• Radial neck fractures are common injuries in children.
• Treatment aims to restore elbow function and prevent long-term complications.
• Percutaneous techniques are frequently employed for these fractures.

Purpose of the Study:

• To compare the clinical outcomes of two percutaneous methods for treating pediatric radial neck fractures: percutaneous K-wire reduction cast immobilization (PKRC) and percutaneous K-wire reduction elastic intramedullary nailing with cast immobilization (PKRNC).
• To evaluate differences in operative time, radiographic alignment, functional scores, and hospitalization requirements between the two treatment groups.

Main Methods:

• Retrospective analysis of 62 pediatric patients with radial neck fractures.
• Group 1 (PKRC): 31 patients treated with K-wire reduction and cast immobilization.
• Group 2 (PKRNC): 31 patients treated with K-wire reduction, elastic intramedullary nailing, and cast immobilization.

Main Results:

• No significant differences were observed in preoperative angulation, immediate postoperative displacement, or 1-month displacement between PKRC and PKRNC groups.
• The Mayo elbow performance score showed no significant difference between the two groups.
• The PKRC group had a significantly shorter operation time (P=0.023) and did not require a second hospitalization for hardware removal, unlike the PKRNC group.

Conclusions:

• Both PKRC and PKRNC achieve satisfactory outcomes for pediatric radial neck fractures.
• PKRC is associated with a shorter operative time and eliminates the need for a second surgery to remove internal fixation.
• Percutaneous K-wire reduction cast immobilization (PKRC) is recommended as an effective and efficient treatment option for radial neck fractures in children.