Displaced fractures of the radial neck in children: Long-term results and prognosis of conservative treatment

Fractures of the radial head or neck in children may lead to radial head deformity and loss of pronation and supination. Trauma may not only be caused by the injury itself, but also may occur secondarily to surgical reduction and manipulation of fracture fragments. Thirty-eight children with displaced radial neck fractures were investigated 2 to 20 years after the initial accident. Whereas radial head deformity was present in 83% of cases, functional disorder was found in only four children (11%). These children had either developed secondary growth disturbances, which had led to a radioulnar synostosis in one case, or they had been treated by open surgical reduction. On follow-up radiographs, all conservatively treated fractures with angulation up to 50 degrees had corrected themselves spontaneously. The high complication rate after open reduction and the poor functional results and inconvenience for the pediatric patient makes conservative treatment of radial neck fractures in children preferable.