Pediatric Radial Neck Fractures: A Systematic Review Regarding the Influence of Fracture Treatment on Elbow Function

Lisette C. Langenberg; Kimberly I.M. van den Ende; Max Reijman; G. J. Boersen; Joost W. Colaris

doi:10.3390/children9071049

Pediatric Radial Neck Fractures: A Systematic Review Regarding the Influence of Fracture Treatment on Elbow Function

Lisette C. Langenberg, Kimberly I.M. van den Ende, Max Reijman, G. J. Boersen, Joost W. Colaris^*

^*Corresponding author for this work

Orthopedics and Sports Medicine

Research output: Contribution to journal › Review article › Academic › peer-review

3 Citations (Scopus)

25 Downloads (Pure)

Abstract

Background: This review aims to identify what angulation may be accepted for the conservative treatment of pediatric radial neck fractures and how the range of motion (ROM) at follow-up is influenced by the type of fracture treatment.

Patients and Methods: A PRISMA-guided systematic search was performed for studies that reported on fracture angulation, treatment details, and ROM on a minimum of five children with radial neck fractures that were followed for at least one year. Data on fracture classification, treatment, and ROM were analyzed.

Results: In total, 52 studies (2420 children) were included. Sufficient patient data could be extracted from 26 publications (551 children), of which 352 children had at least one year of follow-up. ROM following the closed reduction (CR) of fractures with <30 degrees angulation was impaired in only one case. In fractures angulated over 60 degrees, K-wire fixation (Kw) resulted in a significantly better ROM than intramedullary fixation (CIMP; Kw 9.7% impaired vs. CIMP 32.6% impaired, p = 0.01). In more than 50% of cases that required open reduction (OR), a loss of motion occurred.

Conclusions: CR is effective in fractures angulated up to 30 degrees. There may be an advantage of Kw compared to CIMP fixation in fractures angulated over 60 degrees. OR should only be attempted if CR and CRIF have failed.

Original language	English
Article number	1049
Journal	Children
Volume	9
Issue number	7
DOIs	https://doi.org/10.3390/children9071049
Publication status	Published - 14 Jul 2022

Bibliographical note

Funding Information:
The fee for publication of this article was partially paid by the CORAL (Centre for Orthopaedic Research Alkmaar) research fund, and partially by the orthopaedic surgery research fund of the Erasmus Medical Center, Rotterdam, the Netherlands.

Publisher Copyright:
© 2022 by the authors.

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children-09-01049Final published version, 478 KBLicence: CC BY

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@article{47d61077b2f84623945704e03bccd1d8,

title = "Pediatric Radial Neck Fractures: A Systematic Review Regarding the Influence of Fracture Treatment on Elbow Function",

abstract = "Background: This review aims to identify what angulation may be accepted for the conservative treatment of pediatric radial neck fractures and how the range of motion (ROM) at follow-up is influenced by the type of fracture treatment. Patients and Methods: A PRISMA-guided systematic search was performed for studies that reported on fracture angulation, treatment details, and ROM on a minimum of five children with radial neck fractures that were followed for at least one year. Data on fracture classification, treatment, and ROM were analyzed. Results: In total, 52 studies (2420 children) were included. Sufficient patient data could be extracted from 26 publications (551 children), of which 352 children had at least one year of follow-up. ROM following the closed reduction (CR) of fractures with <30 degrees angulation was impaired in only one case. In fractures angulated over 60 degrees, K-wire fixation (Kw) resulted in a significantly better ROM than intramedullary fixation (CIMP; Kw 9.7% impaired vs. CIMP 32.6% impaired, p = 0.01). In more than 50% of cases that required open reduction (OR), a loss of motion occurred. Conclusions: CR is effective in fractures angulated up to 30 degrees. There may be an advantage of Kw compared to CIMP fixation in fractures angulated over 60 degrees. OR should only be attempted if CR and CRIF have failed.",

author = "Langenberg, {Lisette C.} and {van den Ende}, {Kimberly I.M.} and Max Reijman and Boersen, {G. J.} and Colaris, {Joost W.}",

note = "Funding Information: The fee for publication of this article was partially paid by the CORAL (Centre for Orthopaedic Research Alkmaar) research fund, and partially by the orthopaedic surgery research fund of the Erasmus Medical Center, Rotterdam, the Netherlands. Publisher Copyright: {\textcopyright} 2022 by the authors.",

year = "2022",

month = jul,

day = "14",

doi = "10.3390/children9071049",

language = "English",

volume = "9",

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T1 - Pediatric Radial Neck Fractures

T2 - A Systematic Review Regarding the Influence of Fracture Treatment on Elbow Function

AU - Langenberg, Lisette C.

AU - van den Ende, Kimberly I.M.

AU - Reijman, Max

AU - Boersen, G. J.

AU - Colaris, Joost W.

N1 - Funding Information: The fee for publication of this article was partially paid by the CORAL (Centre for Orthopaedic Research Alkmaar) research fund, and partially by the orthopaedic surgery research fund of the Erasmus Medical Center, Rotterdam, the Netherlands. Publisher Copyright: © 2022 by the authors.

PY - 2022/7/14

Y1 - 2022/7/14

N2 - Background: This review aims to identify what angulation may be accepted for the conservative treatment of pediatric radial neck fractures and how the range of motion (ROM) at follow-up is influenced by the type of fracture treatment. Patients and Methods: A PRISMA-guided systematic search was performed for studies that reported on fracture angulation, treatment details, and ROM on a minimum of five children with radial neck fractures that were followed for at least one year. Data on fracture classification, treatment, and ROM were analyzed. Results: In total, 52 studies (2420 children) were included. Sufficient patient data could be extracted from 26 publications (551 children), of which 352 children had at least one year of follow-up. ROM following the closed reduction (CR) of fractures with <30 degrees angulation was impaired in only one case. In fractures angulated over 60 degrees, K-wire fixation (Kw) resulted in a significantly better ROM than intramedullary fixation (CIMP; Kw 9.7% impaired vs. CIMP 32.6% impaired, p = 0.01). In more than 50% of cases that required open reduction (OR), a loss of motion occurred. Conclusions: CR is effective in fractures angulated up to 30 degrees. There may be an advantage of Kw compared to CIMP fixation in fractures angulated over 60 degrees. OR should only be attempted if CR and CRIF have failed.

AB - Background: This review aims to identify what angulation may be accepted for the conservative treatment of pediatric radial neck fractures and how the range of motion (ROM) at follow-up is influenced by the type of fracture treatment. Patients and Methods: A PRISMA-guided systematic search was performed for studies that reported on fracture angulation, treatment details, and ROM on a minimum of five children with radial neck fractures that were followed for at least one year. Data on fracture classification, treatment, and ROM were analyzed. Results: In total, 52 studies (2420 children) were included. Sufficient patient data could be extracted from 26 publications (551 children), of which 352 children had at least one year of follow-up. ROM following the closed reduction (CR) of fractures with <30 degrees angulation was impaired in only one case. In fractures angulated over 60 degrees, K-wire fixation (Kw) resulted in a significantly better ROM than intramedullary fixation (CIMP; Kw 9.7% impaired vs. CIMP 32.6% impaired, p = 0.01). In more than 50% of cases that required open reduction (OR), a loss of motion occurred. Conclusions: CR is effective in fractures angulated up to 30 degrees. There may be an advantage of Kw compared to CIMP fixation in fractures angulated over 60 degrees. OR should only be attempted if CR and CRIF have failed.

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U2 - 10.3390/children9071049

DO - 10.3390/children9071049

M3 - Review article

C2 - 35884033

AN - SCOPUS:85135626727

VL - 9

JO - Children

JF - Children

IS - 7

M1 - 1049

ER -

Pediatric Radial Neck Fractures: A Systematic Review Regarding the Influence of Fracture Treatment on Elbow Function

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