Surgical management of displaced fractures of the neck of the radius in children: open reduction and temporary internal fixation in whom closed reduction has failed: A prospective study

Pediatric radial neck fractures account for 5 to 10% of all elbow fractures. The treatment of radial neck fractures in children varies according to the displacement, angulation, and skeletal maturity. Open reduction is advocated for comminuted fractures and cases where closed reduction has failed. Thus open reduction and temporary internal fixation of pediatric radial neck fractures have to be chosen selectively for apt indications. This study includes 22 children with fractures of the radial neck who were treated at SBMCH, Chromepet between January 2010 and December 2015. Fractures were classified according to the classification system described by Judet et al. The patients are evaluated using MEPS score and radiographs at 8-12 weeks and at 6 months. The patients were followed 12 60 months [mean of 24 months].According to MEPS score 7 [31.81%] had excellent results, 7[31.81%] had good outcomes and 8[36.38%] had fair to poor outcomes. Post op neck angle was excellent to good in 14 [63.64%] and fair to poor in 8[36.37%] patients. Our study established that contrary to other literature, that good results can be obtained in carefully selected cases with gentle manipulative surgery. Younger the age group and earlier the case taken up for surgery better are the functional outcome.