Paediatric Radial Neck Fractures

  • Secondary to valgus load on extended elbow
  • Or secondary to dislocation
  • 50% are metaphyseal, 50% SH variety

Angulation

 Degree of Angulation
Mild0-30°
Mod30-60°
Severe> 60°
Angulation of Paediatric Radial Neck Fractures

Displacement

 Degree of Apposition
Mild> 70% apposition
Mod> 50% apposition
Severe< 50% apposition
Displacement of Paediatric Radial Neck Fractures
  • Significant angulation is tolerated, but little translation is tolerated
  • Look for medial epicondyle in the joint
  • Reduce with varus stress & digital pressure

Treatment

 Treatment
< 30°collar & cuff
>30° or > 3 mm displacedclosed reduction if < 45° angulate acceptif > 45° angulated – surgey
> 60°complete displacement  ORIF
Treatment of Paediatric Radial Neck Fractures

Indications for ORIF

  • Irreducible to < 45°
  • SH IV displaced
  • Complete displacement

Never Excise & discard head