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The outcome of Radial Neck Fracture Treated with Closed/ Open Reduction and Retrograde Kirschner Wires Fixation in
K Sapkota1, N Ranjeet1, P R Onta1
1Department of Orthopedics, Manipal College of Medical Sciences, Phulbari, Pokhara, Nepal.
Insights
Displaced radial neck fractures in children, though rare, can be effectively treated with closed reduction and Kirschner wire stabilization. This method shows excellent clinical and radiological outcomes, offering a safe option for pediatric elbow injuries.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Pediatric Trauma
Background:
- Radial neck fractures are uncommon pediatric elbow injuries (1-5% of all pediatric elbow fractures).
- Non-displaced or minimally displaced fractures are typically managed conservatively.
- Severely displaced or angulated radial neck fractures necessitate surgical intervention.
Purpose of the Study:
- To evaluate the clinical and radiological outcomes of displaced radial neck fractures in children treated with closed reduction and percutaneous intramedullary stabilization.
- To assess functional recovery using the Mayo Elbow Performance Score.
- To analyze the range of motion and radiological healing post-treatment.
Main Methods:
- A cohort of 24 children with displaced radial neck fractures (Judet types II-IV; O'Brien types II-III) was studied.
- All patients underwent closed reduction and retrograde intramedullary stabilization using Kirschner wires.
- Functional outcomes were assessed using the Mayo Elbow Performance Score and range of motion measurements.
Main Results:
- The mean patient age was 8.42 years (62.5% male).
- Excellent or good results were achieved in 83.3% of cases based on the Mayo Elbow Performance Score.
- Radiological evaluation indicated excellent or good fracture alignment and healing in all cases.
Conclusions:
- Closed reduction and retrograde intramedullary Kirschner wire stabilization is a safe and effective treatment for displaced radial neck fractures in children.
- The procedure yields excellent clinical and radiological outcomes with a low complication rate.
- This technique provides a reliable option for managing complex pediatric radial neck fractures.
Abstract:
Background Radial neck fractures in children are rare injuries, representing 1 to 5% of all elbow pediatric fractures. Most of them are non-displaced or slightly displaced and treated conservatively. Severely displaced or angulated radial neck fractures (Judet type III and IV fractures or O'Brien type III radial neck fractures) requires surgical treatment. Objective To study the clinical and radiological outcomes of fractures following closed or open reduction and percutaneous intramedullary stabilization of the displaced radial neck fracture in children. Method There were 24 children with displaced radial neck fracture Judet type II, III and IV fractures O'Brien type II, III who underwent closed reduction and retrograde intramedullary stabilization with Kirschner wires. Functional outcomes were evaluated based on of Mayo Elbow Performance Score. Result The mean age of patients was 8.42 ± 1.82 years with boys 15(62.5%) and girls 9(37.5%) in number. An excellent result was seen in 5(20.8%) cases and good results in 15(62.5%) cases according to the Mayo elbow performance score. Analyzing a passive and active range of motion, 5 had excellent results, 15 had good results and 4 had fair results compared to the normal side. Radiological evaluation showed fracture healing in excellent or good alignment according to Ursei radiological evaluation classification. Conclusion Closed reduction and retrograde intramedullary Kirschner wires stabilization for the displaced radial neck fracture provide excellent clinical and radiological results with few complications.
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