Intramedullary nailing for the treatment of dislocated pediatric radial neck fractures

Abstract

Introduction: Pediatric radial neck fractures represent 5-10% of all elbow fractures. Open reduction allows anatomic fracture fixation but compromises the vulnerable blood supply of the radial head. Intramedullary nailing combines the advantages of closed reduction and stable internal fracture fixation.

Material and methods: During a 6-year-period the medical records of all children sustaining a radial neck fracture treated operatively at our institution were analyzed retrospectively.

Results: Forty-two patients with dislocated fractures of the radial neck were treated with intramedullary nailing. The average age of the patients was 8 years. Thirty-eight patients (90%) could be treated with closed fracture reduction and retrograde nailing. Open fracture reduction was required in 4 (10%) patients, and in 2 patients necrosis of the radial head occurred. Loss of reduction was seen in 7 (17%) patients. Excellent results were found in 38 patients, good results in 2 patients, and poor results in another 2.

Conclusion: The retrograde nailing technique for the treatment of dislocated fractures of the radial neck in pediatric patients is a simple, short and safe procedure.