Simplifying fracture of the radial neck. All information taken from authentic sources.

1. Radial neck fracture
Dr. Ashiqur Rahman
Resident Orthopedics
Dhaka Medical college Hospital

2. Introduction
 In adults a displaced fracture of the radial neck may need open
reduction.
 if so, a pre-contoured locking plate can be applied, carefully placed to
avoid the articular surface during rotation.
 If undisplaced, non-operative management can produce acceptable
results despite a relatively high rate of non-union. Most are
asymptomatic.

3.  In children with radial neck # usually are 04 to 14 years old.
 Primarily because, ossification of the radial head usually
does not begin before 5 years of age.

8.  The normal anatomical angulation of the radial neck in children has
been erroneously diagnosed as a buckle fracture in this area.
 In AP Radiograph lateral angulation varies from 0-15°
 And in lateral radiograph 10° anterior to 5° posterior.

9. How does angulation affect treatment?
(i) < 30°
-No manipulation needed
(ii) 30-60°
- Usually responds to closed reduction
(iii) >60°
- May require surgical intervention
 Most fractures in children are of the radial neck and not the radial
head.

10. Clinical feature:
- Palpation over the radial head and neck is painful.
- Passive forearm pronation and supination is painful.
- A young child may primarily complains wrist pain and the
pressure over the proximal radius may accentuate the referred
wrist pain.
- Wrist pain is secondary to radial shortening and distal radio
ulnar dysfunction.

11. O’Brien classification of Radial neck #

13. Treatment option of Radial neck #
1. Immobilization with no manipulation.
2. Manipulative closed reduction
3. Percutaneous pin reduction
4. Intramedullary pin reduction
5. Open reduction with or without internal fixation
6. Excision of radial head. Or a small head fragment.

14. Non operative methods:
- Younger children angulation less than 20 to 30 degrees.
- A collar and cuff or a simple posterior long cast is enough.
Manipulative closed reduction:
- Angulation up to 40 to 45 degrees.

15. Patterson’s Classic Manipulation Technique (Courtesy:
Prof. Dr. R R Kairy)

16. The Kaufman (Israeli) Technique

17. Metaizeau’s technique for IM reduction of Radial neck #

18. Reduction with the help K-wire

20. Complication:
1. Loss of motion
2. Radial head overgrowth
3. Non union
4. Avascular necrosis.