The Métaizeau technique for pediatric radial neck fracture with elbow dislocation: intraoperative pitfalls and associated forearm compartment syndrome

Abstract

Displaced radial neck fractures in the pediatric population can be treated with retrograde intramedullary nailing of the radius (the Métaizeau technique). This method allows early movement, which may improve functional outcome. Unfortunately, repeated intraoperative attempts with this treatment in challenging fractures can result in compartment syndrome. In this article, we report the cases of 2 patients who underwent the Métaizeau technique for displaced radial neck fractures. In each case, optimal fixation of the radius was impossible because of concurrent elbow instability. Multiple attempts to reduce and stabilize these fractures may cause development or exacerbation of forearm compartment syndrome. The Métaizeau technique has been shown to be an effective method of minimally invasive surgical management of pediatric radial neck fractures. Its success may hinge on the ability of the elbow joint to hold the radial head in position while the implant is driven into the proximal radius in a retrograde fashion. Care should be used when dealing with radial neck fractures associated with elbow dislocation, as they may be difficult to reduce and stabilize. The increased operative time and soft-tissue injury associated with repeated attempts with this method may lead to or worsen compartment syndrome.