Judet type-IV radial neck fractures in children: Comparison of the outcome of fractures with and without bony contact

Acta Orthop. 2016 Oct;87(5):529-32. doi: 10.1080/17453674.2016.1203700. Epub 2016 Jun 27.


Background and purpose - Heavily displaced radial neck fractures in children are sometimes associated with poor outcome. A substantial number of these fractures require open reduction. We hypothesized that Judet type-IV fractures with a completely displaced radial head would result in a worse outcome than radial neck fractures with remaining bony contact. Patients and methods - We analyzed 19 children (median age 9.7 (4-13) years) who were treated for Judet type-IV radial neck fractures between 2001 and 2014. The outcome was assessed at the latest outpatient visit using the Linscheid-Wheeler score at a median time of 3.5 (1-8) years after injury. The patients were assigned either to group A (9 fractures with remaining bony contact between the radial head and the radial neck) or to group B (10 fractures without any bony contact). Results - The 2 groups were similar concerning age and sex. The rate of additional injuries was higher in group B (7/10 vs. 1/9 in group A; p = 0.009). The rate of open reduction was higher in group B (5/10 vs. 0/9 in group A; p = 0.01). Poor outcome was more common in group B (4/10 vs. 0/9 in group A; p = 0.03). In group B, the proportion of children with poor outcome (almost half) was the same irrespective of whether open or closed reduction had been done. Interpretation - The main causes of unfavorable results of radial neck fracture in children appear to be related to the energy of the injury and the amount of displacement-and not to whether open reduction was used.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Bone Nails*
  • Child
  • Child, Preschool
  • Elbow Injuries*
  • Elbow Joint / diagnostic imaging
  • Elbow Joint / physiopathology
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / methods*
  • Humans
  • Male
  • Radius / diagnostic imaging
  • Radius / injuries
  • Radius / surgery*
  • Radius Fractures / diagnosis
  • Radius Fractures / physiopathology
  • Radius Fractures / surgery*
  • Range of Motion, Articular*
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Treatment Outcome