Open Reduction and Stabilization Without Internal Fixation for the Treatment of Displaced Radial Neck Fractures

Area of Science:

• Orthopedic Surgery
• Traumatology
• Pediatric Orthopedics

Background:

• Radial neck fractures are uncommon injuries in both pediatric and adult populations.
• Current treatments like internal fixation carry risks such as nerve palsy and require hardware removal.
• A method for stable fixation without internal implants is desirable.

Purpose of the Study:

• To evaluate the efficacy of open reduction and stabilization for displaced radial neck fractures without using internal fixation.
• To assess the clinical and radiological outcomes of this non-implant technique.

Main Methods:

• Eight patients with radial neck fractures underwent open reduction using a chisel for displacement correction.
• Instability was managed with artificial bone graft substitute, followed by cast immobilization for two weeks.
• Fracture angulation and translation were assessed pre- and post-operatively.

Main Results:

• All patients achieved successful anatomical position maintenance immediately after surgery.
• Mean bone union occurred between 62.1-80.3 days, with excellent functional recovery (mean QuickDASH score 1.1).
• No complications like malalignment, nerve palsy, or avascular necrosis were observed.

Conclusions:

• Open reduction and stabilization without internal fixation can achieve satisfactory outcomes for displaced radial neck fractures.
• Intraoperative stability is crucial; artificial bone grafting is recommended for instability.
• This technique offers a viable alternative to internal fixation, minimizing associated risks.