![]() In cases with a potential risk for secondary dislocation, conventional radiographic controls were performed. 079/2020BO2).Ĭonservative treatment refers to immobilization in an above-the-elbow cast. This study was approved by the local ethical committee (project no. ![]() The data were also acquired and processed according to the latest version of the “World Medical Association Declaration of Helsinki-Ethical Principles for Medical Research Involving Human Subjects”. The data were stored on a computerized database. The authors used clinical charts to collect demographic characteristics, clinical backgrounds, indications for operation, treatment procedures, complications, and postoperative outcomes including radiographic findings and clinical examination results. ![]() This study retrospectively analyses the charts of 100 consecutive patients below 16 years of age with a fracture of the proximal radius treated at our institution between March 2011 and December 2019. In particular, this study focuses on the different fracture types, pitfalls of treatment modalities, and final results. Therefore, the aim of this study is to describe a single-center experience regarding the treatment of a consecutive group of patients with proximal radius fractures. In addition, surgical methods and postoperative treatment are not yet standardized and may lead to the application of disproportionately invasive methods.ĭifferent fracture types, various additional injuries, and a large age range of the patients make a uniform evaluation difficult, while the scientific research concentrates on highly specific issues. Also, the increasing popularity of intramedullary fixation may cause a trend toward surgical interventions as previously described for other pediatric fractures. As a result, overtreatment is an issue in some patients. The potential of growth-related correction is unknown, and the exact mechanisms of remodeling are not fully understood. This dissent may be explained by several points. However, some authors mention complication rates of up to 27–37%. The results after RNF are predominantly described as good in the literature for surgical and conservative concepts. The high potential of spontaneous correction and the vascular supply of the proximal radius make the decision for the respective treatment method demanding. Associated fractures of the olecranon, medial epicondyle, or lateral condyle occur in up to 50% of cases. RNF are predominant among children aged 8–12 years. Both mechanisms cause compression of the radiocapitellar joint. Another possible mechanism, although rare, is a fall on the hyperextended elbow with the forearm in pronounced pronation. The most common injury mechanism is a fall on the outstretched arm with the forearm in supination and an associated valgus thrust. Almost all cases involve radial neck fractures (RNF), and radial head fractures (RHF) represent a rarity in this group. Open surgery and long immobilization periods should be avoided whenever possible.įractures of the proximal radius account for only 1% of all fractures and from 4.5 to 21% of elbow fractures in children. In cases with displacement exceeding growth-related correction, ESIN is the undisputed treatment of choice. ![]() Good results are obtained with conservative treatment throughout. Proximal radial fractures occur predominately without dislocation. Loss of movement was seen in 11% of cases, overall Mayo elbow performance index (MEPI) was 99.8 (90–100), and none of the patients experienced negative impacts on activities of daily life. As a result, two ESIN osteosynthesis were revised, and one radial head resection was performed. Six complications occurred: loss of implant stability ( n = 2), healing in malalignment, pseudarthrosis, radioulnar synostosis, and a persisting hypoesthesia at the thumb. Open reduction was necessary in five cases, and additional immobilization was performed in 32 cases. Surgical treatment was performed in 37 patients (Judet II = 3 III = 22 IV = 5 V = 7) using elastic stable intramedullary nailing (ESIN). Conservative treatment was performed in 63 patients (Judet I = 27 II = 30 III = 6 Mason I = 2) using an above-the-elbow cast for 21 days (6–35). Twenty-seven patients had concomitant injuries. The gender distribution was 62 girls and 38 boys. One hundred patients were documented with a fracture of the proximal radius between 3/2011 and 12/2019. This study performs a retrospective data analysis of 100 consecutive patients with a fracture of the proximal radius treated in a single high-volume pediatric trauma center. ![]() The aim of this study is to describe the management and results of the respective fracture types and different injury characteristics. Pediatric radial neck and head fractures are rare, accounting for only 1% of all fractures in children. ![]()
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