Radial neck fractures in children: A surgical tip using the Metaizeau technique to improve stability of the reduction

Aim: To evaluate early results of management of radial neck fractures with Metaizeau technique in the paediatric age group and to elaborate on a surgical tip to improve stability of the fixation. Method: A retrospective analysis of 21 patients, with fracture radial neck, who underwent closed reduction and internal fixation with elastic intramedullary nailing (Metaizeau technique), was performed. Mean age at injury was eight years, and the average follow-up was 4.5 months (range: 3-6 months). Follow up Clinical and radiological evaluation was performed at first and sixth postoperative weeks. At six weeks following removal of the nail, a clinical assessment was conducted to record the outcomes, and any later follow-up was arranged based on pain and range of motion. Results: We recorded five excellent, eight good, one fair, results for type 3 fractures. For type 4 fractures, we had one excellent, five good and one fair, results. Altogether, we recorded 20 (90.5%) excellent or good results, and 2 (9.5%) fair results. Complications noted were superficial skin infection at the entry site in one patient that required a course of oral antibiotics. Prominent metal work was noticed in 14 cases, which didn't need any further intervention as it did not cause any functional discomfort. Conclusion: With Metaizeau technique, there were reported poor results of about 10% in literature. In our study, with the modification of the shape of the nail tip, we have managed to achieve stable fixation of the reduction without any loss of position and consequently, better outcomes.