Intramedullary elastic nailing of the displaced radial neck fractures in children

Abstract

Objective: The aim of this study was to report the clinical and radiological results of 11 patients withJudet type 3 severely displaced radial neck fractures, who were treated with intramedullary elastic nailŞxation with the help of percutaneous K-wire reduction maneuver (M etaizeau technique).Methods: A total of 11 children (4 boys and 7 girls with a mean age of 7.7 (6e10) years) with Judet type 3radial neck fractures were treated in our clinic between February 2013 and August 2015. The fractureswere evaluated according to Judet classiŞcation system modiŞed by Metaizeau. Reduction andŞxationwas performed within theŞrst 24 h after injury in all patients. All fractures were treated by closedreduction using distal elastic intramedullary nail. Clinical evaluation was performed by measuring elbowrange of motion (ROM) with goniometer, radiological evaluation by assessing fracture healing andfunctional evaluation by using Mayo Elbow Performance Score (MEPS).Results: The mean MEPS score increased from 15 points preoperatively to 88 points postoperatively(range, 12e95 points). Radiological evaluation revealed that all fractures healed with excellent or goodalignment. The meanflexion was 150(range, 145e154), extension 1(range, 0e2), supination 82(range, 80e86), and pronation 83(range, 80e85).Conclusion: Reduction and osteosynthesis of radial neck fractures by intramedullary nailing with thehelp of percutaneous K-wire manipulation appears to be a simple, safe and effective treatment method inchildren.Level of evidence: Level IV, Therapeutic study.