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Kaiser, M; Eberl, R; Castellani, C; Kraus, T; Till, H; Singer, G.
Judet type-IV radial neck fractures in children: Comparison of the outcome of fractures with and without bony contact.
Acta Orthop. 2016; 87(5):529-532
Doi: 10.1080/17453674.2016.1203700
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- Leading authors Med Uni Graz
- Castellani Christoph
- Eibisberger Margarita
- Co-authors Med Uni Graz
- Eberl Robert
- Kraus Tanja
- Singer Georg
- Till Holger
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- Abstract:
- Background and purpose - Heavily displaced radial neck fractures in children are sometimes associated with poor outcome. A substantial number of these fractures require open reduction. We hypothesized that Judet type-IV fractures with a completely displaced radial head would result in a worse outcome than radial neck fractures with remaining bony contact. Patients and methods - We analyzed 19 children (median age 9.7 (4-13) years) who were treated for Judet type-IV radial neck fractures between 2001 and 2014. The outcome was assessed at the latest outpatient visit using the Linscheid-Wheeler score at a median time of 3.5 (1-8) years after injury. The patients were assigned either to group A (9 fractures with remaining bony contact between the radial head and the radial neck) or to group B (10 fractures without any bony contact). Results - The 2 groups were similar concerning age and sex. The rate of additional injuries was higher in group B (7/10 vs. 1/9 in group A; p = 0.009). The rate of open reduction was higher in group B (5/10 vs. 0/9 in group A; p = 0.01). Poor outcome was more common in group B (4/10 vs. 0/9 in group A; p = 0.03). In group B, the proportion of children with poor outcome (almost half) was the same irrespective of whether open or closed reduction had been done. Interpretation - The main causes of unfavorable results of radial neck fracture in children appear to be related to the energy of the injury and the amount of displacement-and not to whether open reduction was used.
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