This study presents a new technique for a closed reduction and internal fixation of displaced radial neck fractures in children. Using image intensification, a small incision is made just proximal to the epiphyseal plate of the radius. A slightly bent Kirschner wire is placed retrograde through the radial metaphysis and up to the level of the fracture. A closed or percutaneous reduction of the radial neck is performed and the intramedullary K-wire is advanced into the head. In 6 cases reported, operating room time averaged 35 minutes, with a mean radiation time of 3 minutes and 30 seconds. No complications were noted and all fractures healed uneventfully. Five of the six patients did well with complete recovery of elbow and forearm motion. One patient developed recurrent angulation and eventual radioulnar synostosis.
Widely displaced fractures of the radial neck in children are difficult to manage. Open reduction can often lead to vascular compromise of the radial head and various techniques have been developed for closed reduction and pinning. This article presents an alternative technique using retrograde intramedullary fixation. It should be included as part of the armamentarium in the surgical treatment of these difficult injuries.