Treatment of Displaced Radial Neck Combined With Olecranon Fractures

The most common fracture in children is the elbow fracture, and the three most common elbow fractures are supracondylar, lateral condylar, and medial epicondylar fractures. Elbow fractures are easy to diagnose and the treatment modalities are studied often. However, proximal radius fractures, which include radial neck and head fractures, remain challenging to diagnose and manage. In addition, proximal radius fractures are often combined with other fractures, most commonly, an olecranon fracture. Most radial neck fractures can be treated conservatively if the displacement is less than 3 mm and the angle is less than 30º. However, for severe Judet type III and type IV radial neck fractures, surgery is inevitable.

This study focused on radial neck fractures combined with an olecranon fracture. In this study, absorbable rods were used for fixation of radial head fractures, and with no need for removal of the inner fixation, we performed anatomy reduction via the same incision with direct vision of the olecranon, and we were able to fix the fractures with Kirschner wires (K-wires). In this retrospective study, we aimed to evaluate a treatment method for severe displaced radial neck combined with olecranon fractures in children using a Boyd incision, absorbable rods, and K-wires.

• Absorbable Rods and Kirschner Wires (Procedure): A Boyd incision was applied in all patients; olecranon fractures were reduced first and fixed with Kirschner wires. Then, the displaced radial neck fractures were reduced and fixed using absorbable rods.

Primary outcomes

• Mayo Elbow Performance Index score [3th month after surgery]: MEPI results were categorized as follows: >90 points, excellent; 81-90 points, good; 61-80 points, fair; and <60 points, poor.

Sex: All, ages: 3 Years to 13 Years

Inclusion Criteria:

* open reduction of severe radial neck fractures combined with an olecranon fractures in the same elbow
* fixation performed using absorbable rods and K-wires

Exclusion Criteria:

* single radial head fractures or single olecranon fractures
* fixation performed with bands
* old fractures,
* Boyd incision was not used,
* guardians did not agree with the surgery

• Yuxi Su, M.D., Principal investigator, Children's hospital of Chongqing Medical Univeristy