Jeffery Type II Fracture of the Radial Neck of a Child: Description of the Lesion and Novel Method of Closed Reduction

The authors describe the treatment of a 13-year-old patient with a severe, posteriorly dislocated, epiphysiolysis fracture of the proximal radius. This is called a Jeffery type II lesion when the epiphysiolysis fracture takes place at the radial neck during the reduction of elbow posterior dislocation, thus causing radial head posterior displacement. There are <30 cases described in the literature about such kind of lesion, and only. Chotel and colleagues has carried out the percutaneous form of treatment. He advocated a varus stress onto the elbow joint so that its subluxation would open the lateral space to facilitate manipulation and head reduction toward its anatomic position. The authors also describe a closed reduction technique for such fracture by using 2 Kirschner wires, whereas the first is inserted into the fracture site, thus acting as a guide and fulcrum, so that the second wire would push the radial head toward its anatomic position. The authors regard that such modification of Chotel and colleagues’ technique is an effective and less aggressive maneuver that reduces the risk of iatrogenic ligament and chondral injuries. The purpose is to demonstrate the surgical technique of the novel, effective, and safe method of treatment to Jeffery type II radial neck pediatric fractures.