Radial Neck Fracture: Operative Treatment (ESIN) “Joy-Stick” Technique
In childhood, the majority of fractures around the proximal radius are radial neck fractures, according to the AO Pediatric Comprehensive classification (Slongo et al., J Pediatr Orthop 26:43–49, 2006; AO pediatric comprehensive classification of long bone fractures (PCCF). AO Publishing, Davos, 2007): 21r- M and 21r-E fractures. With the implementation of the ESIN method, the indication for closed reduction and stabilization has been significantly expanded. So we recommend treating only slightly displaced or absolutely stable fractures conservatively. Conservative treatment means that we do not perform an active reduction. The acceptable displacement depends on the age of the child and the remaining remodeling capacity. Tables 1 and 2 show the possible fracture pattern we recommend for operative treatment on one hand and which needs an additional external reduction support by a “Joy-Stick” technique.
References and Suggested Readings
- Dietz HG, Schmittenbecher PP, Slongo TF, Wilkins KE (2006) AO manual of fracture management. Elastic stable intramedullary nailing (ESIN) in children. Thieme, StuttgartGoogle Scholar
- Lascombe P (2006) Embrochage centromédullaire élastique stable. Elsevier, Masson, Issy-les MoulineauxGoogle Scholar
- Slongo T, Audigé L, Schlickewei W, Clavert JM, Hunter J (2006) Development and validation of the AO pediatric comprehensive classification of long bone fractures by the pediatric expert group of the AO foundation in collaboration with AO clinical investigation and documentation and the international association for pediatric traumatology. J Pediatr Orthop 26:43–49CrossRefPubMedGoogle Scholar
- Slongo T, Audigé L, AO Classification Group (2007) AO pediatric comprehensive classification of long bone fractures (PCCF). AO Publishing, DavosGoogle Scholar