Observations concerning radial neck fractures in children

Twenty-three children with fractures of the radial neck were reviewed. Fractures with an angulation of greater than 60 degrees were treated by open reduction and internal fixation with transarticular Kirschner wires through the humerus and the radius. These broke at the joint in two patients, and we now avoid the humerus by using oblique Kirschner wires. Some limitation of movement, especially of forearm rotation, was more common in children with associated lesions of the same elbow and with open reduction. We think that this reflects the severity of the injury rather than the presence of associated lesions or the surgery itself.