Treatment decision, method of osteosynthesis, and outcome in radial neck fractures in children: a multicenter study.
To determine whether closed elastic-stable intramedullary nailing (ESIN) of radial neck fractures in children is accepted as standard procedure with satisfactory results, a prospective multicenter case collection study was conducted. Sixty-six cases from 12 departments were analyzed during 2 years. Thirty-six fractures of Judet 1 or 2 grade (54.5%) were treated without reduction; all of these fractures showed good to excellent results. Thirty fractures of grade 3 or 4 needed a closed (25 [37.9%]) or open reduction (5 [7.6%]), and 74% of them had good to excellent results. Osteosynthesis was carried out in 26 of the reduced fractures (23 ESIN, 3 Kirschner wire fixation). Using ESIN, 78% of the results were good to excellent. Seven children developed significant restrictions of pronation/supination, including three of the five open reduced fractures. ESIN has found wide acceptance, and the results are satisfactory. Restricted use of open interventions may be the key to improving results.
Schmittenbecher
Peter P
PP
Department of Pediatric Surgery, St. Hedwig's Hospital, Clinical Center Barmherzige Brüder, Regensburg, Germany. schmittenbecher@barmherzige-regensburg.de
Haevernick
Bernd
B
Herold
Arnold
A
Knorr
Peter
P
Schmid
Eckhard
E
D000293:Adolescent; D001864:Bone Wires; D002648:Child; D005594:Fracture Fixation, Intramedullary / Q000379:methods; D006801:Humans; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome