Metaizeau Closed Reduction Technique and Open Reduction Technique for the Surgical Treatment of Pediatric Radial Neck Fractures

Objective: To compare the functional outcomes of pediatric radial neck fractures treated with percutaneous reduction using Kirschner (K) wire with the Metaizeau technique, and that with open reduction plus internal fixation with K-wire. Study Design: Comparative descriptive study. Place and Duration of Study: Haseki Training and Research Hospital Orthopedics and Traumatology Department, from December 2007 to December 2018. Methodology: Children aged under 15 years, with radial neck fractures were inducted. The injury was classified according to Judet classification and the type IV was treated with either of the above technique. The inclusion criteria were a diagnosis of Judet type IV radial neck fracture and a minimum follow-up of 12 months. Exclusion criteria were patients with concomitant elbow fracture, follow-up for <12 months, failure to complete the Mayo Elbow Performance Score (MEPS) functional assessment, patients with missing data. Radiological results were evaluated in accordance with the Ursei Classification. MEPS was used to assess functional development. Results: Forty-seven children (25 boys and 22 girls) aged (5-14 years with mean age of 8.57 +/- 2.3 years were inducted. The surgical approach was the Metaizeau technique in 22 patients and open reduction technique in 25 patients. MEPS in the Metaizeau technique group was 95.2, with excellent results in 15 patients (68%), good results in 7 (31%), and fair or poor results in none of the patients. The mean MEPS in the open reduction / K-wire group was 88, with excellent, good, fair, and poor results in 9 (36%), 12 (48%), 4 (16%), and none of the patients, respectively. Conclusion: Closed reduction using the Metaizeau technique with the elastic stable intramedullary nailing method satisfies all the criteria for minimally invasive bone surgery. This approach was forward to be considerably efficient, with excellent functional and esthetic outcomes and a low rate of complications if the indications and biomechanical principles are considered.