FUNCTIONAL OUTCOME OF DISPLACED PAEDIATRIC RADIAL NECK FRACTURE TREATED BY OPEN REDUCTION –A CASE REPORT

2021 ◽  
pp. 36-37
Author(s):  
K Anusha ◽  
P Archana Babu ◽  
K Srinivasa Reddy
Keyword(s):  
Radial Head ◽  
Open Reduction ◽  
Full Range ◽  
Vascular Supply ◽  
Complete Healing ◽  
Radial Neck Fracture ◽  
Radial Neck ◽  
Epiphyseal Injury ◽  
Neck Fracture ◽  
K Wires

A pediatric radial neck fracture, is still a challenging problem for the treating orthopedic surgeon. We report a pediatric patient presenting with radial neck fracture and results of open reduction and xation with k wires. A 8-year-old right-handed boy fell on an out-stretched left arm after being tackled during playing kabaddi and had a radial neck fracture. At the rst radiologic examination, the anteroposterior and lateral radiographs were showing over 80 degrees of angulation at the radial neck and subluxation of the radiocapitellar joint. We tried to obtain a closed reduction, but we could not succeed. Then, we performed open reduction while preserving medial periosteal continuity and vascular supply of the radial head by meticulous surgical dissection. Sixth-month radiography control and clinical examination conrmed the complete healing of the fracture without any epiphyseal injury. Painless full range of motion without any restriction of pronation and supination was achieved. The patient and his parents were satised with the outcome. We conclude that, if we can preserve medial periosteal continuity and vascularity of the radial head with open reduction, satisfactory results are obtainable.

scholarly journals Late Presenting Pediatric Radial Neck Fracture: A Case Report and Review of the Literature

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kaya Turan ◽  
Cenk Köroglu ◽  
Haluk Çabuk
Keyword(s):  
Case Report ◽  
Radial Head ◽  
Open Reduction ◽  
Full Range ◽  
Vascular Supply ◽  
Complete Healing ◽  
Radial Neck Fracture ◽  
Radial Neck ◽  
Epiphyseal Injury ◽  
Neck Fracture

Introduction: A pediatric radial neck fracture, when the diagnosis is delayed, is still a challenging problem for the treating orthopedic surgeon. We report a pediatric patient with late presenting radial neck fracture and results of open reduction and fixation with Kirschner wires. Case Report: A 13-year-old right-handed girl fell on an out-stretched right arm after being tackled during playing basketball and had a radial neck fracture. However, the diagnosis of her fracture was delayed for 3 weeks. At the first radiologic examination, the anteroposterior and lateral radiographs were showing over 80 degrees of angulation at the radial neck and subluxation of the radiocapitellar joint. We tried to obtain a closed reduction, but we could not succeed. Then, we performed open reduction while preserving medial periosteal continuity and vascular supply of the radial head by meticulous surgical dissection. Sixth-month radiography control and clinical examination confirmed the complete healing of the fracture without any epiphyseal injury. Painless full range of motion without any restriction of pronation and supination was achieved. The patient and her parents were satisfied with the outcome. Conclusions: Even if the diagnosis of pediatric radial fractures is delayed if we can preserve medial periosteal continuity and vascularity of the radial head with open reduction, satisfactory results are obtainable. Keywords: Pediatric, radial neck fracture, open reduction, late diagnosis.

scholarly journals Radial Neck Osteotomy for Malunion of Radial Neck Fracture in Childhood

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Simon Vandergugten ◽  
Serge Troussel ◽  
Bernard Lefebvre
Keyword(s):  
Avascular Necrosis ◽  
Radial Head ◽  
Elbow Joint ◽  
Open Reduction ◽  
Articular Surface ◽  
Coronoid Process ◽  
Radial Neck Fracture ◽  
Radial Neck ◽  
Neck Fracture ◽  
Initial Fracture

In a case of a neglected radial neck fracture in childhood, the management of initial fracture and its complications are subjected to discussion. In children, open reduction should be avoided but an angulation less than 30° must be obtained. Several techniques exist to manage symptomatic malunion in adults, including resection, prosthesis, and osteotomy. When performing an osteotomy, it is important first to preserve an intact osseous hinge to avoid avascular necrosis and second to align the edge of the radial head articular surface with the lateral edge of the coronoid process, in order to avoid overstuffing elbow joint.

scholarly journals Radial Neck Fracture With 180° Rotational Displacement in Pediatrics: A Case Report of a 6-Year-Old Child

2020 ◽  
Vol 7 (2) ◽  
pp. 93-96
Author(s):  
Ali Tabrizi ◽  
◽  
Ahamdreza Afshar ◽  
Hassan Taleb ◽  
◽  
...  
Keyword(s):  
Case Report ◽  
Radial Head ◽  
Conventional Radiography ◽  
Joint Surface ◽  
Rotational Displacement ◽  
Radial Neck Fracture ◽  
Radial Neck ◽  
Elbow Injuries ◽  
Neck Fracture ◽  
Lateral Displacements

Introduction: Radial neck fracture is one of the rare traumas in the upper extremity among the children accounting for 5%-10% of the pediatric elbow injuries. The valgus strain-induced radial neck displacement often ranges from 10° to 90. Rotational displacement with 180° rotation is very rare. Case Presentation: In this case report, we present a 6-year-old child who had radial neck fracture with 180 rotation and joint surface tilt toward the distal direction after falling on her outstretched hand. The close reduction was conducted under the fluoroscopic guide and the radial neck-shaft was restored with 15 angulation. The elbow was immobilized by a long forearm cast for 3 weeks. Based on conventional radiography taken after 3 weeks, a complete union was achieved. Six-month follow-up showed no radial growth disturbance and radial head avascular necrosis. Conclusions: The radial head could be displaced in the form of 180° rotation during the radial neck fracture. In this regard, careful attention to the joint surface is important to minimize the lateral displacements or angulation and to avoid any misdiagnosis. The closed reduction was a successful treatment and caused no complications.

UNUSUAL PATTERN OF ESSEX-LOPRESTI INJURY WITH NEGATIVE PLAIN RADIOGRAPHS OF THE WRIST: A CASE REPORT AND LITERATURE REVIEW

Hand Surgery ◽  
2010 ◽  
Vol 15 (01) ◽  
pp. 41-45 ◽  
Author(s):  
Juan Rodriguez-Martin ◽  
Juan Pretell-Mazzini ◽  
Carlos Vidal-Bujanda
Keyword(s):  
Radial Head ◽  
Radial Head Fracture ◽  
Distal Radioulnar Joint ◽  
Interosseous Membrane ◽  
Radioulnar Joint ◽  
Unusual Pattern ◽  
Radial Neck Fracture ◽  
Radial Neck ◽  
Neck Fracture ◽  
Essex Lopresti

The Essex-Lopresti injury consists of a fracture of the radial head, rupture of the interosseous membrane and disruption of the distal radioulnar joint. The greatest challenge with this injury pattern is the diagnosis, because it is frequently missed and the attention usually focused on the elbow joint. In this paper we report an unusual pattern of Essex-Lopresti injury with a radial neck fracture, a tear of the interosseous membrane and a disruption of the distal radioulnar joint in which initial wrist radiographs did not show significative abnormalities. Open reduction and internal fixation for the radial head fracture was performed. Forearm rotation was locked with two Kirschner wires from ulna to radius to allow interosseous membrane to heal. This case is even more difficult to diagnose than classic Essex-Lopresti pattern because of the absence of radius shortening, due to this specific radius fracture pattern, and also the absence of distal radioulnar joint dislocation. When treating a radial head fracture but also a radial neck fracture, interosseous membrane injury should be suspected to avoid misleading in diagnosis.

scholarly journals Outcome of open reduction and Kirschner wire fixation in pediatric radial neck fracture

2021 ◽  
Vol 24 (4) ◽  
pp. 239-244
Author(s):  
Alireza Rouhani ◽  
Mohammadreza Chavoshi ◽  
Alireza Sadeghpour ◽  
Hossein Aslani ◽  
Mohsen Mardani-Kivi
Keyword(s):  
Range Of Motion ◽  
Closed Reduction ◽  
Open Reduction ◽  
Kirschner Wire ◽  
Primary Treatment ◽  
Radial Neck Fracture ◽  
Radiographic Outcomes ◽  
Radial Neck ◽  
Kirschner Wire Fixation ◽  
Neck Fracture

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.

scholarly journals Better Fixation In Severely Displaced Fracture

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0008
Author(s):  
Shaqirin Safie ◽  
Zulfahrizzat Shamsudin ◽  
Abdul Rauf Ahmad
Keyword(s):  
Open Reduction ◽  
Callus Formation ◽  
Older Patient ◽  
Important Indicator ◽  
Radial Neck Fracture ◽  
Radial Neck ◽  
Fractures In Children ◽  
Elbow Fractures ◽  
Severity Of Injury ◽  
Neck Fracture

Introduction: Fractures of the radial neck are relatively uncommon injuries; the incidence in children is reported to be about 1% of all pediatric fractures and 5% of elbow fractures in children. The radial head may be displaced in any direction, but the most common direction is lateral. Associated injuries may signify a more severe trauma to the elbow. Report: 16 years old boy presented with alleged fall during playing football. Patient slipped during game due to slippery grass. Patient fall with elbow hit the ground. Post trauma complain left elbow swelling, pain and limited range of movement (ROM). X-ray and CT Scan elbow done noted radial neck fracture, completed displacement. Judet classification type IVa. Operation closed manipulative reduction (CMR) and titanium elastic nail system (TENS) performed for this patient. Intraoperatively in view of delayed operation soft callus formed already and make the CMR difficult. Initially we planned to do Metaizeau technique to reduce the fracture but in view of soft callus formation we have to performed Kapanji technique also to release the soft callus formation. Anatomical reduction achieved. Then patient upper limb protected with above elbow backslab for 1 month. [Figure: see text][Figure: see text] Discussions: Treatment of radial neck fracture in adolescenthave to be planned properly. A lot of factor will contribute to final outcome of the injury including age of patient, grade of injury and etc. DE Mattos et al 2016 reported that older patient is more likely to have more severe displacement radial neck fracture requiring open reduction operation. Kaise M et al 2016 reported that the outcome of radial neck fracture appear to be related to severity of displacement rather than surgical manipulation. Metaizeau technique is widely used and recommended. Al-Aubaidi Z et al 2012 say that Metaizeau technique is excellent treatment and patient undergone open reduction had inferior outcome. Conclusion: Radial neck fracture is uncommon injury in children and severity of injury is important indicator for prognosis. Even though older patient and more severe injury can lead to poor outcome. Closed reduction still more favorable than open reduction in managing the fracture

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