Radial Neck Fractures: Introduction and Classification
In childhood the majority of fractures around the proximal radius are radial neck fractures, according the AO Pediatric 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. Real radial head fractures are rare and are not addressed in this case description. The absolute gold standard for the treatment of these fractures is closed indirect reduction and internal fixation according the ESIN (elastic–stable–intramedullary–nailing) technique (Dietz et al. 2006). Open reduction and internal fixation should be avoided because of the associated problems of AVN, unstable fixation, joint stiffness, and radio-ulnar synostosis with bad functional outcomes.
On the other hand, the ESIN method because of it superior results and ease of use leads to a more frequent indications for operative treatment.
In the table below, there is an overview of the actual indication-philosophy and treatment modalities according the fracture type.
References and Suggested Readings
- Dietz HG, Schmittenbecher PP, Slongo TF, Wilkins KE (2006) Elastic stable intramedullary nailing (ESIN) in children, AO manual of fracture management. 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 26:43–49CrossRefGoogle Scholar
- Slongo T, Audigé L, AO Classification Group (2007) AO Pediatric comprehensive classification of long bone fractures (PCCF). AO Publishing, DavosGoogle Scholar