[Problem of fracture of the radius head in the child]

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Traumatology

Background:

• Fractures of the proximal radius in children require careful treatment selection.
• Understanding complications and long-term outcomes is crucial for pediatric fracture management.

Purpose of the Study:

• To establish guidelines for choosing between conservative and operative treatment for pediatric proximal radius fractures.
• To highlight complications and failures associated with different treatment modalities.

Main Methods:

• Retrospective study of 21 children with proximal radius fractures.
• Analysis of treatment choices (conservative vs. operative) and their outcomes.
• Classification of fractures, including radial head and radial neck types.

Main Results:

• True intraarticular radial head fractures are uncommon in children.
• Comminuted radial head fractures with elbow dislocation have the worst prognosis.
• Displaced marginal fractures (<3 mm) are suitable for conservative, functional treatment.
• 18 patients had Judet type III and IV radial neck fractures; operative therapy was generally avoided despite low failure rates.

Conclusions:

• Conservative management is preferred for less severe proximal radius fractures in children.
• Severe fractures, particularly those with dislocation, present significant treatment challenges and poor outcomes.
• A cautious approach to operative intervention is warranted, even with historically low failure rates.