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Percutaneous treatment of radial neck fractures in adult patients

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Introduction

Radial neck fractures in adults are rare, but outcomes are often poor. Closed reduction and internal fixation (CRIF) technique has been advocated for the treatment of minimally displaced fractures in children, with a few reports on adult subjects. The aim of the present paper is to investigate mid-term results of a CRIF technique in adults with retrograde intramedullary K-wires in Mason’s type II and III fractures. The proposed technique yields to good anatomical reduction of displaced neck fractures, faster rehabilitation, and easier hardware removal after fracture consolidation.

Material and methods

A consecutive series of 17 patients were treated with closed reduction and intramedullary osteosynthesis, and outcomes were retrospectively evaluated. Elbow X-ray (XR) and CT scan were obtained preoperatively. Objective assessment before surgery and at an average 36-month follow-up included active and passive elbow range of motion (ROM). Functional evaluation was carried out through the collection of the Mayo Elbow Performance Score (MEPS), the Disabilities of the Arm, Shoulder, and Hand (DASH) score, and Elbow Self-Assessment Score (ESAS). XR at last follow-up was evaluated.

Results

The cohort included 10 males and seven females, with a mean age of 32 years. Patients returned for a follow-up evaluation at a mean of 36 months (range 6–43 m) form the surgery. The DASH score revealed good to excellent outcomes with a mean of 6.32 ± 10.24 points at last follow-up. The ESAS was 98.35 ± 1.89, indicating a non-restricted elbow function. Acceptable radiographic healing was achieved in all patients.

Conclusions

The advocated technique is promising for obtaining good reduction and stabilization, and good to excellent satisfaction for patients. Given the challenging technique, the learning curve could be long and initial results unsatisfactory. More research with larger cohorts and improved study design could be carried out, comparing the technique with the current choice of treatment (ORIF, radial head resection).

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Acknowledgements

At.S. performed the surgical procedures, S.G., E.P., and Al.S. collected the data. G.T., Al.S, and S.G. wrote the manuscript. At.S. edited the manuscript, supervised the work, and performed a final review. All the authors read and approved the final manuscript. No funding received for the present manuscript and clinical study.

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No funding received for the present manuscript and clinical study.

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  1. Casa Di Cura Villa Stuart, Via Trionfale, 5952, 00135, Roma, Italy

    Silvio Giannetti, Alessandro Smimmo, Guglielmo Torre, Andrea Stancati, Ernesto Pagano & Attilio Santucci

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  1. Silvio Giannetti
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Correspondence to Alessandro Smimmo.

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The authors declare that they have not competing interests.

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Only data regarding common clinical practice were retrospectively collected, used for diagnosis and full monitoring of the treatment. The investigation was carried out with the respect of the Declaration of Helsinki and according to the standards of Good Clinical Practice.

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Giannetti, S., Smimmo, A., Torre, G. et al. Percutaneous treatment of radial neck fractures in adult patients. Eur J Orthop Surg Traumatol 34, 1413–1418 (2024). https://doi.org/10.1007/s00590-023-03811-8

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