Prognostic factors for intramedullary nailing in radial neck fracture in children

Hemmer, Julien; Happiette, Adèle; Muller, Florence; Barbier, Dominique; Journeau, Pierre

doi:10.1016/j.otsr.2020.05.014

Cited by 8 publications

(8 citation statements)

References 23 publications

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“…Poor results following OR may be caused by damage of the blood supply [ 70 ], proximal radioulnar joint adhesion [ 8 ], or periarticular ossification [ 57 , 71 ]. Potentially, the focal damage to tissues due to trauma plays a role [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Radial Neck Fractures: A Systematic Review Regarding the Influence of Fracture Treatment on Elbow Function

et al. 2022

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Background: This review aims to identify what angulation may be accepted for the conservative treatment of pediatric radial neck fractures and how the range of motion (ROM) at follow-up is influenced by the type of fracture treatment. Patients and Methods: A PRISMA-guided systematic search was performed for studies that reported on fracture angulation, treatment details, and ROM on a minimum of five children with radial neck fractures that were followed for at least one year. Data on fracture classification, treatment, and ROM were analyzed. Results: In total, 52 studies (2420 children) were included. Sufficient patient data could be extracted from 26 publications (551 children), of which 352 children had at least one year of follow-up. ROM following the closed reduction (CR) of fractures with <30 degrees angulation was impaired in only one case. In fractures angulated over 60 degrees, K-wire fixation (Kw) resulted in a significantly better ROM than intramedullary fixation (CIMP; Kw 9.7% impaired vs. CIMP 32.6% impaired, p = 0.01). In more than 50% of cases that required open reduction (OR), a loss of motion occurred. Conclusions: CR is effective in fractures angulated up to 30 degrees. There may be an advantage of Kw compared to CIMP fixation in fractures angulated over 60 degrees. OR should only be attempted if CR and CRIF have failed.

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Section: Discussionmentioning

confidence: 99%

Pediatric Radial Neck Fractures: A Systematic Review Regarding the Influence of Fracture Treatment on Elbow Function

et al. 2022

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“…When considering the good results as successes, the successful treatment rate could reach 73.6%. Hemmer et al [11] reported a 73% excellent result and 11% good results according to Metaizeau criteria. When using their own evaluation criteria, they concluded 71% good results and 29% poor results.…”

Section: Article In Pressmentioning

confidence: 98%

A retrospective review of 101 operatively treated radial neck fractures in children and analysis of risk factors for functional outcomes

Yang

Zuo

et al. 2022

Injury

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“…Open reduction and internal fixation have been associated with a greater loss in range of motion and increased rates of osteonecrosis and synostosis compared to closed reduction techniques[ 3 , 25 , 36 ]. However, these results are controversial due to open reduction being more frequently used in fractures with a higher degree of displacement and more concomitant injuries.…”

Section: Treatment and Outcomementioning

confidence: 99%

“…Radio-ulnar synostosis is associated with open treatment of proximal radius fractures. Therefore, the incidence of synostosis is most effectively reduced by using minimally invasive techniques when possible[ 3 , 25 , 36 ]. Furthermore, it is the senior authors’ practice to remove bone dust using gel or water and avoid interfering with the radio-ulnar space.…”

Section: Complicationsmentioning

confidence: 99%

Diagnosis, treatment and complications of radial head and neck fractures in the pediatric patient

Macken

Eygendaal

Bergen

2022

WJO

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Radial head and neck fractures represent up to 14% of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient. In up to 39% of proximal radius fractures, there is a concomitant fracture, which can easily be overlooked on the initial standard radiographs. The treatment options for proximal radius fractures in children range from non-surgical treatment, such as immobilization alone and closed reduction followed by immobilization, to more invasive options, including closed reduction with percutaneous pinning and open reduction with internal fixation. The choice of treatment depends on the degree of angulation and displacement of the fracture and the age of the patient; an angulation of less than 30 degrees and translation of less than 50% is generally accepted, whereas a higher degree of displacement is considered an indication for surgical intervention. Fractures with limited displacement and non-surgical treatment generally result in superior outcomes in terms of patient-reported outcome measures, range of motion and complications compared to severely displaced fractures requiring surgical intervention. With proper management, good to excellent results are achieved in most cases, and long-term sequelae are rare. However, severe complications do occur, including radio-ulnar synostosis, osteonecrosis, rotational impairment, and premature physeal closure with a malformation of the radial head as a result, especially after more invasive procedures. Adequate follow-up is therefore warranted.

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Prognostic factors for intramedullary nailing in radial neck fracture in children

Cited by 8 publications

References 23 publications

Pediatric Radial Neck Fractures: A Systematic Review Regarding the Influence of Fracture Treatment on Elbow Function

Pediatric Radial Neck Fractures: A Systematic Review Regarding the Influence of Fracture Treatment on Elbow Function

A retrospective review of 101 operatively treated radial neck fractures in children and analysis of risk factors for functional outcomes

Diagnosis, treatment and complications of radial head and neck fractures in the pediatric patient

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