Pediatric Proximal Radius Fracture and Reduction Techniques: An Educational Review

Pediatric radial neck fractures are rare, comprising about a tenth of all elbow injuries in children ( 1 ) . They typically affect the children between 4 to 14 years of age with a peak of incidence ranging between 8 and 10 years of age ( 2 ) . Because radial head ossification starts at age 5 and is completed when the physis closes at 14 years of age for boys and 17 for girls ( 3 ) . The most common mechanism of this fracture is falling over an out stretched extended hand with a valgus force ( 4 ) . The most common radial neck fractures are extra - physeal fractures of the metaphysis or Salter - Harris I or II fractures of the proximal radial physis ( 4 ) . Closed fractures are more common than open ones and near half of these fractures are associated with the ipsilateral elbow dislocation, olecranon fractures, and ruptured collateral ligaments ( 5 ) . The classification systems in radial neck fractures including the Jeffery, O’Brien, and Judet and Letournel classification systems are the most commonly cited o nes in the literature ( 3 ) . The management of radial neck fractures is based on fracture angulation, dislocation , and skeletal maturity ( 6 ) . Treatment options that have been used for fractures with dislocation are closed reduction, percutaneous pin - assisted reduction, Metaizeau technique (elastic intramedullary nailing), and if the se closed methods are not successful, open reduction with or without internal fixation can be used ( 6 ) . Although good results have been reported after these varying treatment methods, the optimal treatment is still unclear ( 7 ) .