Internal Fixation With Absorbable Rods for the Treatment of Displaced Radial Neck Fractures in Children

J Pediatr Orthop. 2016 Dec;36(8):797-802. doi: 10.1097/BPO.0000000000000572.

Abstract

Background: The treatment of radial neck fractures with complete displacement or severe displacement and an angle of >30 degrees is controversial. The currently used methods, including the Metaizeau technique, are associated with drawbacks such as imperfect reduction, epiphyseal damage, and delayed functional recovery. To overcome these drawbacks, we used absorbable rod fixation followed by early functional training for the treatment of displaced radial neck fractures in children.

Methods: In this study, 68 patients (age, 4 to 12 y; average, 8.4 y; average angle, 58 degrees; average displacement, 53%) with radial neck fractures with Salter-Harris grades II to IV underwent lateral elbow open reduction and absorbable rod fixation. At 3 weeks postoperatively, the patients' plaster casts were removed, and functional training was started.

Results: Anatomic reduction was achieved in all patients. We followed-up 68 patients for 6 months to 4 years (average, 41 mo). No cases of radial nerve injury, radial bone necrosis, myositis ossificans, and postoperative infection were observed. The functional recovery was "excellent" in 43 patients, "good" in 13 patients, "average" in 12 patients, and "bad" in 0 patients, according to the Morrey evaluation standard.

Conclusion: Open reduction with absorbable rod fixation for the treatment of displaced radial neck fractures in children was feasible and was a choice in children.

Level of evidence: Therapeutic II.

MeSH terms

  • Absorbable Implants*
  • Child
  • Child, Preschool
  • Elbow Joint / surgery*
  • Epiphyses / physiopathology
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / methods*
  • Humans
  • Internal Fixators*
  • Male
  • Postoperative Complications / physiopathology
  • Radial Nerve / physiopathology
  • Radiography
  • Radius / surgery
  • Radius Fractures / diagnostic imaging
  • Radius Fractures / rehabilitation
  • Radius Fractures / surgery*
  • Recovery of Function
  • Treatment Outcome