Background: The treatment of radial neck fractures in children varies according to the displacement, angulation, and skeletal maturity. There is a general agreement that displaced radial neck fractures with more than 30 angulations (Judet type III and IV fractures) should be surgically treated. There are several treatment possibilities for Judet type III and IV fractures including percutaneous pin reduction, elastic stable intramedullary nailing (ESIN), and open reduction with or without internal fixation. In this retrospective study we compared the clinical and radiographical outcomes, and complications following intramedullary versus percutaneous pinning in displaced radial neck fractures in children. Materials and methods: Between 2000 and 2011, 20 patients were treated using closed reduction: in 12 cases we used percutaneous pinning, and in 8 cases we used ESIN. According to Judet classification the two groups were composed as follows: 10 (77 %) type III and 3 (23 %) type IV fractures in the percutaneous pinning group; 4 (57 %) type III, and 3 (43 %) type IV fractures in the ESIN group. Results: After an average of 42 months, excellent results in Mayo elbow performance scores (MEPS) were obtained in 71 and 69 % of ESIN and percutaneous pinning groups respectively, with good results in the remaining cases apart from one fair case (8 %) in the percutaneous pinning group. After a radiological evaluation, all fractures healed in excellent or good alignment. When comparing the two groups, the subjects treated with the ESIN technique had higher range of motion (ROM) in flexion, extension and pronation. No patients developed complications, except three cases of asymptomatic enlargements of the radial head, reported only in the percutaneous pinning group. Conclusion: In this research the clinical outcome, assessed with the MEPS, and the radiological alignment, were comparable between the subjects that were treated with percutaneous pinning and those with ESIN techniques; whereas the ESIN technique demonstrated higher ROM in flexion, extension and pronation. The ESIN technique seems to be the ideal approach both for the higher ROM values and for the absence of complications. © 2012 The Author(s).

Management of displaced radial neck fractures in children: Percutaneous pinning vs. elastic stable intramedullary nailing / Tarallo, Luigi; Mugnai, Raffaele; Fiacchi, Francesco; Capra, Francesco; Catani, Fabio. - In: JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY. - ISSN 1590-9921. - 14:4(2013), pp. 291-297. [10.1007/s10195-013-0252-0]

Management of displaced radial neck fractures in children: Percutaneous pinning vs. elastic stable intramedullary nailing

Tarallo, Luigi;Mugnai, Raffaele;Fiacchi, Francesco;Catani, Fabio
2013

Abstract

Background: The treatment of radial neck fractures in children varies according to the displacement, angulation, and skeletal maturity. There is a general agreement that displaced radial neck fractures with more than 30 angulations (Judet type III and IV fractures) should be surgically treated. There are several treatment possibilities for Judet type III and IV fractures including percutaneous pin reduction, elastic stable intramedullary nailing (ESIN), and open reduction with or without internal fixation. In this retrospective study we compared the clinical and radiographical outcomes, and complications following intramedullary versus percutaneous pinning in displaced radial neck fractures in children. Materials and methods: Between 2000 and 2011, 20 patients were treated using closed reduction: in 12 cases we used percutaneous pinning, and in 8 cases we used ESIN. According to Judet classification the two groups were composed as follows: 10 (77 %) type III and 3 (23 %) type IV fractures in the percutaneous pinning group; 4 (57 %) type III, and 3 (43 %) type IV fractures in the ESIN group. Results: After an average of 42 months, excellent results in Mayo elbow performance scores (MEPS) were obtained in 71 and 69 % of ESIN and percutaneous pinning groups respectively, with good results in the remaining cases apart from one fair case (8 %) in the percutaneous pinning group. After a radiological evaluation, all fractures healed in excellent or good alignment. When comparing the two groups, the subjects treated with the ESIN technique had higher range of motion (ROM) in flexion, extension and pronation. No patients developed complications, except three cases of asymptomatic enlargements of the radial head, reported only in the percutaneous pinning group. Conclusion: In this research the clinical outcome, assessed with the MEPS, and the radiological alignment, were comparable between the subjects that were treated with percutaneous pinning and those with ESIN techniques; whereas the ESIN technique demonstrated higher ROM in flexion, extension and pronation. The ESIN technique seems to be the ideal approach both for the higher ROM values and for the absence of complications. © 2012 The Author(s).
14
4
291
297
Management of displaced radial neck fractures in children: Percutaneous pinning vs. elastic stable intramedullary nailing / Tarallo, Luigi; Mugnai, Raffaele; Fiacchi, Francesco; Capra, Francesco; Catani, Fabio. - In: JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY. - ISSN 1590-9921. - 14:4(2013), pp. 291-297. [10.1007/s10195-013-0252-0]
Tarallo, Luigi; Mugnai, Raffaele; Fiacchi, Francesco; Capra, Francesco; Catani, Fabio
File in questo prodotto:
File Dimensione Formato  
Tarallo2013_Article_ManagementOfDisplacedRadialNec.pdf

accesso aperto

Tipologia: Versione dell'editore (versione pubblicata)
Dimensione 490.71 kB
Formato Adobe PDF
490.71 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11380/1167379
Citazioni
  • ???jsp.display-item.citation.pmc??? 19
  • Scopus 33
  • ???jsp.display-item.citation.isi??? ND
social impact