The treatment of displaced radial neck combined with olecranon fractures with absorbable rods and Kirschner wires in pediatric patients.

Abstract

Objective: The aim of this study was to evaluate the outcomes of pediatric patients who were treated for olecranon and displaced radial neck fractures with absorbable rods and Kirschner wires.

Methods: Thirty-one patients (20 male, 11 female), aged from 3 to 13 years old with olecranon and displaced radial neck fractures treated with absorbable rods and Kirschner wires, were included in this retrospective, single-center study. All radial neck fractures were Judet type IV, and there were 17 type C and 14 type D olecranon fractures. The follow-up time ranged from 26 to 56 months (average 35.8 months). The Boyd approach was used first to reduce olecranon fractures and fix them with Kirschner wires. Thereafter, radial neck fractures were reduced and fixed with absorbable rods. Patients' functional outcomes were assessed using the Mayo Elbow Performance Index score.

Results: Results were excellent in 19 patients, good in 8 patients, fair in 2 patients, and poor in 2 cases according to the Mayo Elbow Performance Index score. The rate of excellent and good outcomes was 87.1%. The average Mayo Elbow Performance Index score was 91.5 points. Three patients showed radial nerve injuries preoperatively, which were assessed intraoperatively. No nerve repair was required, and all nerve injuries recovered within 3 months.

Conclusion: This study has shown us that using a Boyd approach for open reduction and fixation with absorbable rods and K-wires is feasible for olecranon and severely displaced radial neck fractures in pediatric patients.

Level of evidence: Level IV, Therapeutic study.