Treatment decision, method of osteosynthesis, and outcome in radial neck fractures in children: a multicenter study.

Abstract: To determine whether closed elastic-stable intramedullary nailing (ESIN) of radial neck fractures in children is accepted as standard procedure with satisfactory results, a prospective multicenter case collection study was conducted. Sixty-six cases from 12 departments were analyzed during 2 years. Thirty-six fractures of Judet 1 or 2 grade (54.5%) were treated without reduction; all of these fractures showed good to excellent results. Thirty fractures of grade 3 or 4 needed a closed (25 [37.9%]) or open reduction (5 [7.6%]), and 74% of them had good to excellent results. Osteosynthesis was carried out in 26 of the reduced fractures (23 ESIN, 3 Kirschner wire fixation). Using ESIN, 78% of the results were good to excellent. Seven children developed significant restrictions of pronation/supination, including three of the five open reduced fractures. ESIN has found wide acceptance, and the results are satisfactory. Restricted use of open interventions may be the key to improving results.