Study of Short-Term Outcome of Surgically Managed Displaced Pediatric Radial Neck Fractures: A Case Series.

Abstract

Pediatric radial neck fractures are relatively rare elbow injuries commonly seen in children between eight to 12 years of age. Judet type III and Judet type IV radial neck fractures require surgical intervention for optimal functional outcomes. The present study evaluates the functional results of Judet type III and IV radial neck fractures operated at a single center. This is a retrospective study conducted by using medical records of nine patients who had displaced radial neck fractures (Judet type III and type IV) treated at our institute which is a tertiary trauma care centerbetween January 2012 andDecember 2021. 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). Results: The mean age of the patients was 9.14 ± 2.2 years (range: four to 11 years). Seven (77.8%) patients were males and two (22.2%) patients were females. The right side was the most commonly injured side (right at 67%, left at 33%). Five (55%) cases were of Judet type III and four (45%) cases were of Judet type IV.Three cases treated with closed reduction and intramedullary nailing by the Metaizeau technique had excellent functional results. Among two patients treated with percutaneous pin leverage and intramedullary nailing by the Metaizeau technique, one patient had an excellent outcome, and the other had a good outcome. Among four casestreated with open reduction and K-wire fixation, two patients had good outcomes, one patient had a fairoutcome, and one patient had a poor outcome. The majority of moderately to severely displaced pediatric radial neck fractures which need intervention can be managed by the closed reduction technique of Metaizeau with or without pin leverage with excellent to good functional outcomes at short-term follow-up. Some cases need open reduction which also has good to fair outcomes. Initial trauma and associated injuries seem to play a role in the outcome rather than the treatment method per se. However, a larger sample size and longer follow-up are needed for comparisons and for arriving atbetter and definitive conclusions.