REVIEW  PEDIATRIC UPPER LIMB FRACTURE 

Minerva Orthopedics 2021 February;72(1):49-58

DOI: 10.23736/S2784-8469.20.04062-X

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Radial neck fractures in children

Maurizio DE PELLEGRIN ¹ ✉, Lorenzo MARCUCCI ¹, Giovanni PRATI ¹, Tobias ROSENLECHNER ², Desiree MOHARAMZADEH ¹

¹ Unit of Pediatric Orthopedics and Traumatology, IRCCS San Raffaele Hospital, Milan, Italy; ² Kepler University Hospital, Linz, Austria

Radial neck fractures make up 1% of all pediatric fractures and 5-10% of pediatric elbow fractures. Associated injuries such as olecranon fracture or elbow luxation are not uncommon findings. Treatment options are conservative (cast without reduction), closed reduction, percutaneous reduction and fixation with K-wire, percutaneous reduction and intramedullary fixation, open reduction with internal fixation. Child age, bone remodeling capacity and fracture angulations cut-offs play a key role in the choice of the most appropriate treatment technique. The majority of radial head fractures are conservatively treated, especially those with <30° of angulation in children younger than 10 years of age. Open reduction usually leads to unsatisfactory results and minimally invasive technique, such as closed reduction and intramedullary nailing, are the gold standard treatment and should performed whenever possible. The most feared complication is stiffness, leading to a reduced functionality. Imaging techniques such as US are important for radial head fractures diagnosis, especially in children younger than 5 years of age where the radial head is hardly visualized at X-ray. US-guidance is also useful for intra-operative fracture reduction.

KEY WORDS: Radial neck fracture; Closed and open reduction; Ultrasound; Annular ligament; Intramedullary nailing