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

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.

2021 ◽  
pp. 36-37
Author(s):  
K Anusha ◽  
P Archana Babu ◽  
K Srinivasa Reddy

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.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kaya Turan ◽  
Cenk Köroglu ◽  
Haluk Çabuk

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.


Hand Surgery ◽  
2013 ◽  
Vol 18 (03) ◽  
pp. 389-392 ◽  
Author(s):  
Soo-Min Cha ◽  
Hyun-Dae Shin ◽  
Kyung-Cheon Kim ◽  
Jae-Hwang Song

Introduction: Non-union of radial neck fractures is not common in adults, and surgical treatment is rarely required. This case report documents non-union of the radial neck with persistent pain around the elbow joint and tenderness over the neck of the radius, limited range of motion for 12 months. The authors performed an iliac bone graft and temporary K-wire fixation for non-union of the radial neck after an isolated radial neck fracture. Case presentation: A 54-year-old woman slipped with her hand outstretched 12 months prior to presentation. She was diagnosed with a radial neck fracture, but her injury was eventually diagnosed as a non-union fracture, and she was transferred to our hospital. The patient had tenderness of the radial head and neck and an increasing tendency of pain in the forearm during external rotation with resistance. Flexion was a maximum of 80°, extension was limited to 20°, and internal rotation and external rotation were decreased to 60°. On plain radiographs, a clear radiolucent shadow was present between the bone fragment and radius. After the autogenous iliac bone graft, a temporary K-wire was fixed, and at eight weeks postoperatively, the bone was united. The patient is in the month 24 of postoperative follow-up and is able to perform daily activities without tenderness. Conclusion: If elbow joint pain, tenderness, and limitation of range of motion are present in non-union of radial neck fracture, surgical treatment is necessary. If there is no injury to the ligament around the elbow or instability, the authors consider bone graft and temporary K-wire fixation as an excellent treatment option for bony union and early exercise of the joint.


2020 ◽  
Vol 7 (2) ◽  
pp. 93-96
Author(s):  
Ali Tabrizi ◽  
◽  
Ahamdreza Afshar ◽  
Hassan Taleb ◽  
◽  
...  

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.


Hand Surgery ◽  
2010 ◽  
Vol 15 (01) ◽  
pp. 41-45 ◽  
Author(s):  
Juan Rodriguez-Martin ◽  
Juan Pretell-Mazzini ◽  
Carlos Vidal-Bujanda

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.


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.


Sign in / Sign up

Export Citation Format

Share Document