Displaced Radial Neck Fractures in Children: Association of the Metaizeau and Bohler Surgical Techniques

Objectives: To evaluate the results of surgical treatment of displaced radial neck fractures in children using an association of the Bohler reduction technique and the intramedullary fixation described by Metaizeau. Methods: Of the 68 children diagnosed with radial neck fractures, 28 (41.1%) were classified as O'Brien type III and surgically treated by the association of Bohler and Metaizeau techniques between December 1998 and April 2007. Two patients were excluded for loss to follow-up, with a total of 26 patients (38.2%) remaining in the study group. The mean follow-up period was 52 +/- 3.2 months (range, 1.7 to 10y). Results: Consolidation was achieved in all the fractures after 5 weeks postoperatively. None of the patients presented perioperative complications or infections. Only 1 child developed pain and loss of motion, requiring surgical revision. According to Tibone and Stoltz classification, 17 children (65.3%) healed with excellent results, 6 children(23%) with good results, 2 children (7.6%) with fair results, and 1 (3.8%) with poor results. Conclusions: This association of techniques presents an excellent option for O'Brien type III fractures of the radial neck. It is easily executed, does not require elbow arthrotomy, and shows few complications. Level of Evidence: This is a therapeutic study level IV (case series).