Modified Metaizeau technique for displaced radial neck fracture in adults

Abstract

Background and purpose Few studies have been reported about closed treatment of the radial neck fractures in adults, which most often are found in children. A prospective study was conducted to evaluate the results of modified Metaizeau technique in the management of displaced radial neck fracture in adults. Patients and methods A total of 12 adults with displaced radial neck fractures were selected after excluding patients with combined neck and head fractures and patients younger than 16 years. After closed reduction, two or more K-wires were inserted from the midshaft of radius in a retrograde direction to stabilize the reduced head. The Mayo elbow performance score was used for final clinical assessment. A proposed scale by authors was used for radiological evaluation. Results Using the modified Masson classification, there were nine type IIb and three type IIIb fractures. After a mean follow-up of 38 months (range: 22–60 months), 10 patients were clinically rated excellent and two were good. Two patients had skin irritation and painful bursitis at the buried ends of K-wires; otherwise, no cases of superficial or deep infection, K-wire breakage or migration, and tendon or nerve injury were indicated. Asymptomatic nonunion was detected in two patients. According to the proposed radiological scale, six patients were excellent, four good, and two poor. Conclusion Closed manipulation and retrograde intramedullary pinning is a minimally invasive technique allowing stable fixation of displaced radial neck fractures in adults, with excellent to good outcomes and low complication rate.