Percutaneous reduction and leverage fixation using K-wires in paediatric angulated radial neck fractures

摘要

Purpose: We evaluated the usefulness of percutaneous reduction and leverage fixation using K-wires in children with radial neck fractures. Materials and methods: Between 2006 and 2008, we evaluated 13 paediatric patients with radial neck fractures who had been observed for at least two years and underwent percutaneous reduction and leverage fixation using K-wires. We measured radial angulation and radial translation using preoperative, postoperative and final follow-up radiographs, and we clinically investigated range of motion and carrying angle according to Steele's grading system. Results: Excellent clinical results were achieved in 11 (84.6%) patients, good results in one (7.6%) and fair results in one (7.6%). There were no poor results. The patient in whom fair results were achieved also had an olecranon fracture, which was treated conservatively. Complications such as nonunion, infection, iatrogenic nerve injury and periarticular ossification were minimal. Radioulnar synostosis was absent between the radial neck fracture and the greenstick fracture of the olecranon. Growth arrest in the proximal radial epiphysis was also absent. Conclusion: Percutaneous reduction and leverage fixation using K-wires in children with radial neck fractures is a recommended surgical treatment that can achieve recovery of normal radial angulation and elbow motion.