Displaced radial neck fractures in children

Forty-eight children with displaced fractures of the radial neck were studied. Five types of injury were seen, that associated with a valgus strain being the most common. Good results were obtained in just over one-half of the cases. It is concluded that treatment of these fractures should be by closed means whenever possible. It is generally unwise to attempt operative correction unless the radial head remains displaced or the residual angulation approaches 45 degrees. Open reduction should be checked by intraoperative radiographs. Internal fixation is seldom necessary and has its complications. Late manipulation of the fracture causes additonal trauma and the results are bad. Avascular necrosis and radio-ulnar synostosis were the two most disabling complication encountered.