Treatment options for radial neck fractures in children
Abstract
Fractures of the neck of the radius in children are an unsolved and difficult problem. It is a comparatively rare injury and constitutes 5-10% of all elbow fractures. Its prognosis has been considered to be relatively good by many. On the other hand, these fractures remain a source of considerable controversy and have many possible complications that are usually hazardous for the elbow function. The complex anatomy of the elbow and its vascular blood supply makes treatment challenging. The radial head and its blood supply can be damaged by the original trauma and/or by surgical trauma, such as open reduction or forceful manipulations. The choice of treatment is determined by the degree of radial head angulation, which also affects the long-term results. Severe angulation and translation increases the risk of complications, mainly malunion, avascular necrosis of the head, cubitus valgus and stiffness of the joint. Conservative treatment is usually successful for the nondisplaced and minimally displaced fractures. Many studies have postulated that fractures with moderate or severe angulation require reduction. Several methods have been described for fracture reduction, but they are not without complications. In January 1980, Metaizeau proposed intramedullary nailing as a surgical option for the treatment of radial neck fractures. The main advantage of intramedullary nailing is that it simultaneously allows accurate and stable reduction without disturbing the blood supply. © 2009 Future Medicine Ltd.
Description
Keywords
avascular necrosis , fracture nonunion , fracture reduction , human , immobilization , intramedullary nailing , Kirschner wire , medical decision making , nerve paralysis , open reduction , postoperative pain , prognosis , radius fracture , radius neck fracture , review , surgical technique , valgus deformity