Radiological and functional outcomes of modified Metaizeau technique in displaced radial neck fractures

2021 ◽  
Vol 87 (2) ◽  
pp. 235-241
Author(s):  
Ökkeş Bilal ◽  
Ali Murat Kalender ◽  
Burçin Karslı ◽  
Volkan Kılınçoğlu ◽  
Mustafa Kınaş ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Good Choice ◽  
Radial Neck Fracture ◽  
Radial Neck ◽  
Fractures In Children ◽  
Radial Neck Fractures ◽  
Neck Fracture ◽  
Elbow Function ◽  
Poor Outcomes

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.

scholarly journals Closed reduction and percutaneous intramedullary pinning of displaced radial neck fracture in a 12 years old child: reduction technique and outcome

2020 ◽  
Vol 6 (4) ◽  
pp. 854
Author(s):  
Sunil Chandrashekar ◽  
Jagadish Laxmansa Katwa ◽  
Amlan Singh
Keyword(s):  
Closed Reduction ◽  
Forearm Fracture ◽  
Kirschner Wire ◽  
Fracture Dislocation ◽  
Radial Neck Fracture ◽  
Radial Neck ◽  
Radial Neck Fractures ◽  
Intramedullary Pinning ◽  
Fracture Dislocations ◽  
Neck Fracture

<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>

scholarly journals Percutaneous leverage technique for reduction of radial neck fractures in children: technical tips

2020 ◽  
Vol 14 (2) ◽  
pp. 118-124
Author(s):  
Colyn J. Watkins ◽  
Caleb M. Yeung ◽  
Emily Rademacher ◽  
Dennis E. Kramer
Keyword(s):  
Case Series ◽  
Intramedullary Fixation ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Small Incision ◽  
Radial Neck Fracture ◽  
Radial Neck ◽  
Fractures In Children ◽  
Radial Neck Fractures ◽  
Neck Fracture

Purpose Paediatric radial neck fractures are challenging to treat. Multiple strategies exist for reduction and fixation; there is no clear consensus on the best surgical technique to achieve reduction. The percutaneous leverage technique is a method for reduction of radial neck fractures that has previously been described by Wallace, though there is a lack of published literature on this technique. We present a technical note and a modest case series on our modification to the percutaneous leverage technique accompanied by intramedullary fixation. Methods We describe a retrospective series of patients who underwent the modified percutaneous leverage technique for paediatric radial neck fracture reduction followed by flexible intramedullary nail fixation at a single Level I trauma centre from 2008 to 2016. This technique involves making a small incision over the dorsal border of the ulna and using a blunt curved surgical forceps to dissect towards the ulnar border of the radius just distal to the radial neck fracture site. The curved forceps is then used to push the radial shaft away from the ulnar shaft which reduces the radial neck fracture. Intramedullary fixation is then utilized to stabilize the reduction. Pre- and postoperative radiographs and clinical data from the medical record were reviewed, and patient, injury and treatment characteristics as well as complication rates are summarized. Results We successfully treated a series of eight radial neck fractures with the modified percutaneous leverage technique. This technique allows for a small incision and a minimally invasive method for the reduction of paediatric radial neck fractures. This allowed for subsequent intramedullary fixation and early postoperative elbow mobilization. In our series, no patients developed synostoses or sustained peripheral nerve injuries using this technique. Conclusion The modified percutaneous leverage technique followed by intramedullary fixation is a safe and effective technique for fixation of displaced paediatric radial neck fractures. Level of Evidence Level IV

scholarly journals Paediatric Radial Neck Fracture Fixation by Metaizeau Technique - Surgical Technique and Outcome

2021 ◽  
Vol 8 (17) ◽  
pp. 1100-1104
Author(s):  
Tarak Chandra Halder ◽  
Divyanshu Kumar ◽  
Biplab Chatterjee
Keyword(s):  
Functional Outcome ◽  
Intramedullary Nailing ◽  
Fracture Fixation ◽  
Invasive Technique ◽  
Retrograde Intramedullary Nailing ◽  
Radial Neck Fracture ◽  
Radial Neck ◽  
Radial Neck Fractures ◽  
Neck Fracture

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

scholarly journals Treatment Outcome of Métaizeau Technique of Intramedullary Pinning in Pediatric Displaced Radial Neck Fracture

2020 ◽  
Vol 18 (1) ◽  
pp. 26-30
Author(s):  
Prateek Karki ◽  
Roshani Ranabhat ◽  
Aman Shah
Keyword(s):  
Treatment Outcome ◽  
Closed Reduction ◽  
Functional Score ◽  
Excellent Outcome ◽  
Percutaneous Reduction ◽  
Radial Neck Fracture ◽  
Radial Neck ◽  
Intramedullary Pinning ◽  
Neck Fracture ◽  
Type 3

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.

scholarly journals Percutaneous leverage reduction with two Kirschner wires combined with the Métaizeau technique versus open reduction plus internal fixation with a single Kirschner-wire for treating Judet IV radial neck fractures in children

2019 ◽  
Vol 47 (11) ◽  
pp. 5497-5507 ◽  
Author(s):  
Xiangping Du ◽  
Lirong Yu ◽  
Zhigang Xiong ◽  
Gan Chen ◽  
Jun Zou ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
The Novel ◽  
Kirschner Wires ◽  
Radial Neck ◽  
Novel Treatment ◽  
Fractures In Children ◽  
Radial Neck Fractures ◽  
Elbow Function ◽  
K Wires

Objective To compare the clinical effectiveness of a novel approach, percutaneous leverage reduction using two Kirschner-wires (k-wires) combined with the Métaizeau technique, versus open reduction plus internal fixation with k-wire for the treatment of Judet IV radial neck fractures in children. Methods Thirty-four patients with Judet IV radial neck fractures were treated either with percutaneous leverage reduction using two k-wires and the Métaizeau technique (n = 16) or open reduction plus internal fixation with k-wire (n = 18). Patient data including sex, age, time from trauma to surgery, fracture type, follow up, postoperative healing time, X-ray studies, elbow function, and complications were collected. Results There were no significant differences in patient characteristics between the two treatment groups. In postoperative elbow function assessment, 93.8% of patients in the group that underwent the novel treatment approach had a score of excellent or good, compared with 83.3% of patients in the open reduction and internal fixation with k-wire group. Furthermore, no postoperative complications were reported in patients in the novel treatment group, compared with 5 patients in the open reduction and internal fixation with k-wire group. All patients in both groups were classified as excellent or good according to Métaizeau criteria in postoperative X-ray assessment. Conclusions Compared with the open reduction and internal fixation with k-wire approach, percutaneous leverage reduction using two k-wires combined with the Métaizeau technique can significantly increase the minimally invasive reduction rate, and represents an attractive strategy for the treatment of Judet IV radial neck fractures in children.

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
Keyword(s):  
Emergency Department ◽  
Functional Outcome ◽  
Closed Reduction ◽  
Elbow Dislocation ◽  
Procedural Sedation ◽  
Radial Neck Fracture ◽  
Reduction Techniques ◽  
Radial Neck ◽  
Traumatic Dislocation ◽  
Neck Fracture

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.

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