Medial Displacement of the Radial Shaft with Fracture of the Radial Neck and Proximal Ulna

Abstract

Introduction: Fractures of the neck and head of the radius in children are relatively uncommon, constituting 4% to 7% of elbow fractures and dislocations. A child with a fracture of the radial neck and proximal ulna with complete medial displacement of the radial shaft is presented and the classification of the injury is discussed. Objective: To assess the medial displacement of the radial shaft with fracture of the radial neck and proximal ulna. Materials & Methods: This was a retrospective study conducted at Dept. of Ortho-Surgery, Patuakhali Medical College Hospital, Patuakhali, Bangladesh from January 2018 to December 2021. Twelve patients who had displaced radial neck fractures (Judet type III and type IV) treated. Patients were assessed for functional outcome by Mayo elbow performance score (MEPS), the Tibone and Stoltz functional criteria, and for complications with the average follow-up of four years (range: six months to seven years). Inclusion criteria were Judet type III and type IV radial neck fractures, open physis of radial neck at the time of fracture, minimum follow up time of six months. Exclusion criteria were open fractures and Judet type I and type II radial neck fractures. Results: The mean age of the patients was 9.12±2.2 years (range: 4 to 14 years). Nine (75%) patients were males and three (25%) patients were females. The right side was the most commonly injured side (right at 68% and left at 32%). 60% cases were of Judet type III and IV 40% cases were of Judet type IV. The mean fracture angulation of the series was 56.5 degrees (range 33.2 degrees to 79.2 degrees). Five patients had isolated radial neck fractures and five patients had associated proximal ulna fractures and two patients had associated posterolateral elbow dislocation. Six cases required open reduction and K-wire fixation as closed and percutaneous pin leverage techniques did not achieve acceptable reduction. The mean follow-up of all patients was four years ............