scholarly journals Iatrogenic radial neck fracture on closed reduction of elbow dislocation

CJEM ◽  
2013 ◽  
Vol 15 (06) ◽  
pp. 389-391
Author(s):  
Prasad Ellanti ◽  
Dermot O'Farrell

ABSTRACTTraumatic dislocation of the elbow is rare in children and can most often be managed in the emergency department using procedural sedation and closed reduction with good functional outcome. Radiographs must be evaluated for associated avulsions and fractures around the elbow. We present the case of a 14-year-old girl who sustained a fracture of the radial neck subsequent to repeated attempts at closed reduction of a pure posterior elbow dislocation that was missed on postreduction radiographs. Careful use of reduction techniques and avoidance of repeated forceful manipulations is emphasized.

2021 ◽  
Vol 87 (2) ◽  
pp. 235-241
Author(s):  
Ökkeş Bilal ◽  
Ali Murat Kalender ◽  
Burçin Karslı ◽  
Volkan Kılınçoğlu ◽  
Mustafa Kınaş ◽  
...  

The management of displaced radial neck fractures in children is still a controversial topic. The objective of this study is to examine the outcomes of modified Metaizeau technique in the children with displaced radius neck fractures. The retrospective study included 15 children with displaced radial neck fracture with an angulation of more than 30° who were managed with the use of leverage technique by mosquito clamps and internal fixation with elastic stable intramedullary nailing (ESIN). Radiological and functional assessments were performed during follow-up. Additionally, the patients were evaluated using Mayo Elbow Per- formance Score (MEPS). All the children could be managed with clamp-assisted closed reduction. The average duration of follow up was 25.5 ± 6.1 months (15-36 months). An excellent elbow function was achieved in all but one patient. Based on Metaizeau classification, excellent, good, fair, and poor outcomes were achieved in 11, 1, 2, and 1 patients, respectively. The average postoperative MEPS score was 98.7 ± 5.1 (80-100). Clamp-assisted closed reduction and fixation with ESIN is a good choice in the children with displaced radial neck fractures. This technique is associated with good functional and radiologic outcomes in the medium-term. Further studies are warranted with larger sample sizes.


Author(s):  
Sunil Chandrashekar ◽  
Jagadish Laxmansa Katwa ◽  
Amlan Singh

<p>Fracture of the radial neck are uncommon injuries in the pediatric age group. In children, they may present as radial neck fractures, a component of forearm fracture-dislocations, or as isolated fracture-dislocations. Most of the displaced radial neck fractures with more than 30<sup>0</sup> angulations (Judet type III and IV fractures) should be surgically treated. An unusual variant of radial neck fracture with dislocation of the radial head to the radial side without associated nerve injury. The fracture-dislocation was fixed with closed reduction and Kirschner wire under image intensifier. The patient is being followed up for 6 months. Operative treatment with closed reduction and intramedullary pinning has better correction of angulation and rotation compared to closed reduction techniques with angulation of 30<sup>0</sup> or more with 10<sup>0</sup> of rotation. we achieved a supination of 80<sup>0</sup> and a pronation of 50<sup>0</sup>.</p>


2020 ◽  
Vol 18 (1) ◽  
pp. 26-30
Author(s):  
Prateek Karki ◽  
Roshani Ranabhat ◽  
Aman Shah

Introduction: Displaced radial neck fracture in children when poorly managed results in deformity of elbow and incapacitates patient’s daily activities due to compromised forearm motion, hence they require careful attention. Aims: The aim of this study is to assess the outcome of Métaizeau Technique in displaced radial neck fracture in Children. Methods: This hospital based study evaluated the treatment outcome of 35 patients with an average age of 9.34 years (range, 6 – 14 years), who presented with displaced radial neck fracture; and were treated by Métaizeau technique of intramedullary pinning by Kirschners (K) wire at Nepalgunj Medical College, Kohalpur from April 2017 to January 2020. Only Judet’s type 3 and 4 fractures were included in this study. Close reduction was attempted in all cases. All patients were followed up for an average of 8.4 months (range, 6-12 months). Functional outcome was assessed as per Métaizeau functional score. Results: All fractures united at an average of 3.77 0.84 months (meanSD). Twenty seven patients had type 3 fracture and remaining 8 had type 4a fracture. Twenty five (92.5%) patients with type 3 fracture exhibited excellent results; while three patients (37.5%) with type 4a fracture had excellent outcome. Closed reduction produced excellent outcome in all patients while 80.95% patients with percutaneous reduction had excellent result. Conclusion: Outcome depends on initial fracture type and mode of reduction. Closed reduction should be preferred over an open reduction in order to achieve superior outcome.


2021 ◽  
Vol 24 (4) ◽  
pp. 239-244
Author(s):  
Alireza Rouhani ◽  
Mohammadreza Chavoshi ◽  
Alireza Sadeghpour ◽  
Hossein Aslani ◽  
Mohsen Mardani-Kivi

Background: Radial neck fracture in children is rare. This study attempted to evaluate the outcome of surgically treated patients and any associated complications.Methods: This study evaluated 23 children under 15 years of age with radial neck fracture who were treated with open reduction between 2006 and 2016 to determine their range of motion, postoperative complications, and radiographic outcomes. The results were assessed clinically using the Mayo clinic elbow performance score. Results: The mean follow-up duration for patients was 34.6 months. The average postoperative angulation was 3.6º. Hypoesthesia was reported in only 9% of patients, and none of the patients complained of postoperative pain. The postoperative X-ray results were excellent in 60% and good in 40%. No radiographic complications were identified. The Elbow score was excellent in 87% and good in 13% (mean score, 96.74). There was a statistical relationship between range of motion limitations and age, degree of fracture, initial displacement, and surgical pin removal time.Conclusions: Although most patients accept the closed reduction method as a primary treatment, the present study suggests that an open-reduction approach has been associated with optimal therapeutic outcomes for patients in whom closed reduction was not satisfactory or indicated.


2021 ◽  
Vol 8 (17) ◽  
pp. 1100-1104
Author(s):  
Tarak Chandra Halder ◽  
Divyanshu Kumar ◽  
Biplab Chatterjee

BACKGROUND Radial neck fractures in children are serious injuries with frequent sequelae when the tilt exceeds 60 degrees. Conservative treatment is often inadequate in such cases and open reduction may produce iatrogenic complications. Displaced radial neck fractures in the paediatric population can be treated with retrograde intramedullary nailing of the radius (the Metaizeau technique). This method allows early post-operative movement and thus has high functional outcome. The purpose of this case series was to evaluate the functional outcome of Metaizeau technique. METHODS This is a prospective study in which follow-up of 9 cases with radial neck fracture treated with Metaizeau technique was done. Clinical and radiological evaluation was done at 2 weeks, 4 weeks, 6 weeks and 6 months. Active range of motion of flexion and extension at elbow and forearm rotation was noted at 6 weeks along with pain score and Mayo Elbow Performance Score (MEPS). Radiological assessment was also done at 6 weeks regarding union. RESULTS 8 out of 9 cases had radiological union at 6 weeks. 1 case was lost to follow-up. Excellent result was obtained in all 8 cases. Range of flexion-extension, supinationpronation were identical in all 8 cases. 1 case developed pressure bursitis at entry site. CONCLUSIONS Metaizeau technique for radial neck fracture fixation is simple, safe, soft tissue sparing, minimally invasive technique giving excellent functional and cosmetic results with minimal complication. KEYWORDS Metaizeau Technique, Retrograde Intramedullary Nailing, Radial Neck Fracture, MEPS


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