Late Presenting Pediatric Radial Neck Fracture: A Case Report and Review of the Literature

Abstract

Introduction: A pediatric radial neck fracture, when the diagnosis is delayed, is still a challenging problem for the treating orthopedic surgeon. We report a pediatric patient with late presenting radial neck fracture and results of open reduction and fixation with Kirschner wires. Case Report: A 13-year-old right-handed girl fell on an out-stretched right arm after being tackled during playing basketball and had a radial neck fracture. However, the diagnosis of her fracture was delayed for 3 weeks. At the first radiologic examination, the anteroposterior and lateral radiographs were showing over 80 degrees of angulation at the radial neck and subluxation of the radiocapitellar joint. We tried to obtain a closed reduction, but we could not succeed. Then, we performed open reduction while preserving medial periosteal continuity and vascular supply of the radial head by meticulous surgical dissection. Sixth-month radiography control and clinical examination confirmed the complete healing of the fracture without any epiphyseal injury. Painless full range of motion without any restriction of pronation and supination was achieved. The patient and her parents were satisfied with the outcome. Conclusions: Even if the diagnosis of pediatric radial fractures is delayed if we can preserve medial periosteal continuity and vascularity of the radial head with open reduction, satisfactory results are obtainable. Keywords: Pediatric, radial neck fracture, open reduction, late diagnosis.

Delayed Presenting Radial Neck Epiphysiolysis Managed with Open Reduction and Internal Fixation with K Wires: A Case Report and Review of Literature

“…Gutierrez-De La Iglesia et al studied 51 patients with Judet Types 3 and 4 fractures and concluded that there were no significant differences in functional outcome and complications between closed and open reduction [ 10 ]. Turan et al reported a case of radial neck fracture 3 weeks old managed with open reduction and internal fixation with K-wires and had good functional and radiological outcome [ 11 ]. Fracture displacement is the independent predictor of functional outcome irrespective of the technique of reduction.…”

Comparison of midterm efficacy of Kirschner wires and elastic intramedullary nails after closed reduction of Judet type 3 radial neck fractures in children: a multicenter study

“…Radial neck fractures account for 5%–10% of elbow fractures in children and usually occur between 8 and 11 years of age ( 1 ). The treatment of radial neck fractures in children is challenging, and misdiagnosis or delayed treatment may result in malunion or non-union of the radial neck, resulting in limited elbow movement ( 2 ). Judet classification is a commonly used clinical classification method for children with radial neck fractures ( 3 ), which is divided into five types according to the Angle between the vertical line at both ends of the radial head fracture and the longitudinal axis of the radial axis.…”