Acta Orthop Belg. 2021 Jun;87(2):235-241.
The management of displaced radial neck fractures in children is still a controversial topic. The objective of this study is to examine the outcomes of modified Metaizeau technique in the children with displaced radius neck fractures. The retrospective study included 15 children with displaced radial neck fracture with an angulation of more than 30° who were managed with the use of leverage technique by mosquito clamps and internal fixation with elastic stable intramedullary nailing (ESIN). Radiological and functional assessments were performed during follow-up. Additionally, the patients were evaluated using Mayo Elbow Per- formance Score (MEPS). All the children could be managed with clamp-assisted closed reduction. The average duration of follow up was 25.5 ± 6.1 months (15-36 months). An excellent elbow function was achieved in all but one patient. Based on Metaizeau classification, excellent, good, fair, and poor outcomes were achieved in 11, 1, 2, and 1 patients, respectively. The average postoperative MEPS score was 98.7 ± 5.1 (80-100). Clamp-assisted closed reduction and fixation with ESIN is a good choice in the children with displaced radial neck fractures. This technique is associated with good functional and radiologic outcomes in the medium-term. Further studies are warranted with larger sample sizes.
儿童桡骨颈骨折的治疗仍然存在争议。本研究旨在探讨改良 Metaizeau 技术治疗桡骨颈骨折的效果。该回顾性研究纳入了 15 例桡骨颈骨折伴成角>30°的儿童，采用蚊式钳杠杆复位技术，并采用弹性髓内钉（ESIN）内固定。随访时进行影像学和功能评估。此外，采用 Mayo 肘部功能评分（MEPS）对患者进行评估。所有患儿均采用夹辅助闭合复位。平均随访时间为 25.5±6.1 个月（15-36 个月）。除 1 例外，所有患儿的肘关节功能均恢复良好。根据 Metaizeau 分类，11 例、1 例、2 例和 1 例患儿的疗效分别为优、良、可和差。术后平均 MEPS 评分为 98.7±5.1（80-100）。夹辅助闭合复位和 ESIN 固定是治疗儿童桡骨颈骨折的一种较好选择。该技术在中期具有良好的功能和影像学效果。需要进一步进行更大样本量的研究。
