Diagnosis, treatment and complications of radial head and neck fractures in the pediatric patient.

Autor:	Macken AA; Department of Orthopedic Surgery, Amphia Hospital, Breda 4818 CK, Noord-Brabant, Netherlands., Eygendaal D; Department of Orthopedic Surgery and Sports medicine, Erasmus Medical Centre, Rotterdam 3015 GD, South-Holland, Netherlands., van Bergen CJ; Department of Orthopedic Surgery, Amphia Hospital, Breda 4818 CK, Noord-Brabant, Netherlands. cvanbergen@amphia.nl.
Jazyk:	angličtina
Zdroj:	World journal of orthopedics [World J Orthop] 2022 Mar 18; Vol. 13 (3), pp. 238-249. Date of Electronic Publication: 2022 Mar 18 (Print Publication: 2022).
DOI:	10.5312/wjo.v13.i3.238
Abstrakt:	Radial head and neck fractures represent up to 14% of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient. In up to 39% of proximal radius fractures, there is a concomitant fracture, which can easily be overlooked on the initial standard radiographs. The treatment options for proximal radius fractures in children range from non-surgical treatment, such as immobilization alone and closed reduction followed by immobilization, to more invasive options, including closed reduction with percutaneous pinning and open reduction with internal fixation. The choice of treatment depends on the degree of angulation and displacement of the fracture and the age of the patient; an angulation of less than 30 degrees and translation of less than 50% is generally accepted, whereas a higher degree of displacement is considered an indication for surgical intervention. Fractures with limited displacement and non-surgical treatment generally result in superior outcomes in terms of patient-reported outcome measures, range of motion and complications compared to severely displaced fractures requiring surgical intervention. With proper management, good to excellent results are achieved in most cases, and long-term sequelae are rare. However, severe complications do occur, including radio-ulnar synostosis, osteonecrosis, rotational impairment, and premature physeal closure with a malformation of the radial head as a result, especially after more invasive procedures. Adequate follow-up is therefore warranted. Competing Interests: Conflict-of-interest statement: All authors declare no conflict of interest for this article. (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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