Displaced Jeffery Type 2 Radial Neck Fracture Managed by a Modified Métaizeau Technique: A Case Report.

Introduction: The radial neck fractures in children are uncommon injures and more so in the settings of an associated elbow dislocation. Radial neck fracture, with 90° posterior rotation of the articular surface with respect to its normal axis, is a characteristic feature of rare Jeffery type 2 injury. This injury pattern is reported as sporadic reports or small series in the literature. Most of the reported cases have been managed by operative intervention with either open or percutaneous reduction and K-wire fixation. Despite the fact that isolated radial neck fractures have been managed frequently by the retrograde intra-medullary wire fixation technique as described by Métaizeau, its modified utilization as standalone treatment has rarely been described for Jeffery type 2 injury, to the best knowledge of the authors.

Case report: We, hereby report our experience of a displaced Jeffery type 2 radial neck fracture, associated with the posterior elbow subluxation in a 13-year-old male. The injury was finally treated with open relocation of the displaced radial head to the radius neck followed by retrograde fixation of the radial head with one retrograde intramedullary K-wire as a modified Métaizeau technique. Gradual healing of the fracture, stable elbow, and painless activities of daily living were noted along with normal regain of pre-injury elbow function. No complication or instability was noted and excellent Mayo Elbow performance score in the follow-up of 13 months.

Conclusion: The peculiar injury pattern of Jeffery type 2 radial neck fracture warrants early recognition and appropriate management for the optimal functional outcome and also to avoid complication. Open reduction of the displaced radial head and fixation with Métaizeau technique is viable option for the management of this rare injury.