Neck Osteotomy for Malunion of Neglected Radial Neck Fractures in Children: A Report of 2 Cases

Background Radial neck fractures are a common injury in children as a result of a fall on an extended and supinated outstretched hand. Methods We present 2 cases of osteotomy of the neck of the radius performed in 2 children with neglected radial neck fractures. Results Preoperatively, both patients complained of pain and severely reduced mobility of the elbow. Surgery was performed at 6 weeks and 3 months, respectively, after the initial injury and the 2 children were reviewed at 6 and 16 months follow-up. Osteotomies healed within the usual time and no avascular necrosis of the radial head, proximal radioulnar synostosis, or myositis ossificans were observed. The Mayo Elbow Performance Index Score improved significantly after the operation with the 2 patients rated as excellent. Conclusions In this small series, we present a novel technique of proximal osteotomy of the radius to correct this deformity in children. Level of Evidence Case series, level IV evidence.

[1]  R. Moreno-Domínguez,et al.  [Radial head and neck fractures in children]. , 2012, Revista espanola de cirugia ortopedica y traumatologia.

[2]  A. Majed,et al.  Late diagnosis and treatment of a paediatric radial neck fracture , 2006 .

[3]  J. Metaizeau.  Reduction and osteosynthesis of radial neck fractures in children by centromedullary pinning. , 2005, Injury.

[4]  P. Josefsson,et al.  Fractures of the radial head and neck treated with radial head excision. , 2004, The Journal of bone and joint surgery. American volume.

[5]  H. Schreiber,et al.  Angioarchitektur von ulna und radius und ihre praktische relevanz , 1994, Langenbecks Archiv für Chirurgie.

[6]  P. Waters,et al.  Radial Neck Fracture Nonunion in Children , 2001, Journal of pediatric orthopedics.

[7]  M. Ikeda,et al.  Function after early radial head resection for fracture: A retrospective evaluation of 15 patients followed for 3-18 years , 2000, Acta orthopaedica Scandinavica.

[8]  A. Pappas,et al.  Excision of the radial head in patients younger than 18 years. , 1999, Journal of pediatric orthopedics.

[9]  H. Schreiber,et al.  [Angioarchitecture of the ulna and radius and their practical relevance]. , 1994, Langenbecks Archiv fur Chirurgie.

[10]  L. Klenerman,et al.  Management of radial neck fractures in children: a retrospective analysis of one hundred patients. , 1993, Journal of pediatric orthopedics.

[11]  H. Graham,et al.  Angulated radial neck fractures in children. A prospective study of percutaneous reduction. , 1992, The Journal of bone and joint surgery. British volume.

[12]  J. Fowles,et al.  Observations Concerning Radial Neck Fractures in Children , 1986, Journal of pediatric orthopedics.

[13]  D. Roy.  Radioulnar synostosis following proximal radial fracture in child. , 1986, Orthopaedic review.

[14]  Ž. Mikić,et al.  Late results in fractures of the radial head treated by excision. , 1983, Clinical orthopaedics and related research.

[15]  J. Tibone,et al.  Fractures of the radial head and neck in children. , 1981, The Journal of bone and joint surgery. American volume.

[16]  L. Gripenberg,et al.  Fracture of the radial neck in children. A long-term follow-up study of 43 cases. , 1978, Acta orthopaedica Scandinavica.

[17]  J. Newman.  Displaced radial neck fractures in children. , 1977, Injury.

[18]  C. Jeffery.  Fractures of the neck of the radius in children. Mechanism of causation. , 1972, The Journal of bone and joint surgery. British volume.

[19]  E. R. Jones,et al.  Displaced fractures of the neck of the radius in children. , 1971, The Journal of bone and joint surgery. British volume.

[20]  O. Vostal.  [Radius neck fractures in childhood]. , 1970, Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca.

[21]  W. R. Welply.  Fractures in children. , 1966, Manitoba medical review.

[22]  P. O'Brien.  Injuries Involving the Proximal Radial Epiphysis , 1965, Clinical orthopaedics and related research.

[23]  F. M. Smith,et al.  Epiphyseal injuries of the radial head and neck. , 1953, American journal of surgery.

[24]  C. Cogbill.  Fracture of the Neck of the Radius , 1900 .