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Management of Severely Displaced Radial Neck Fractures in Children: A Systematic Review and Meta-analysis of Outcomes

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Abstract

Background

This systematic review is an attempt to provide an evidence-based analysis of literature on management of severely displaced radial neck fractures (with > 60° displacement) in children.

Material and Methods

A systematic literature search was conducted to identify all original articles published between 01/01/1999 and 20/01/17 on surgical treatment of radial neck fractures in children in the following databases: MEDLINE, EMBASE, and CINAHL PLUS. Studies reporting pre-operative fracture displacement and post-operative outcomes according to standard outcome measures were included.

Results

Out of 887 studies identified on initial search, 48 were eligible for full-text review and 14 studies with a total of 173 patients were included in the final review. The overall success rate after severely displaced radial neck fractures in skeletally immature patients was 87% (95% CI, 82%, 92%). Closed reduction methods reported higher success rate of 90% (95% CI, 85%, 95%) compared to open reduction methods 77% (95% CI, 63%, 89%).

Conclusion

The average rate of patients achieving excellent/good outcomes following surgical management after severely displaced radial neck fractures in this review is better than reports from previous reviews. Considering the limitations in current evidence base including lack of direct comparison of techniques and small study samples, large comparative studies controlling for possible confounders are merited.

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Authors and Affiliations

  1. Department of Trauma and Orthopaedics, East Surrey Hospital, Canada Avenue, Redhill, RH15RH, UK

    Ashish M. Narang & Murlidhar Bhat

  2. National Guideline Alliance, Royal College of Obstetrics and Child Health, London, UK

    Anuja A. Pandey

  3. Department of Orthopaedics, East Surrey Hospital, Canada Avenue, Redhill, RH1 5RH, UK

    Ashish M. Narang

Authors
  1. Ashish M. Narang
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  2. Anuja A. Pandey
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  3. Murlidhar Bhat
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Contributions

Concepts: AMN, AAP, and MB. Design: AMN, AAP, and MB. Definition of intellectual content: AMN, AAP, and MB. Literature search: AMN and AAP. Data acquisition: AMN, AAP, and MB. Data analysis: AMN, AAP, and MB. Statistical analysis: AMN and AAP. Manuscript preparation: AMN, AAP, and MB. Manuscript editing: AMN, AAP, and MB. Manuscript review: AMN, AAP, and MB. Guarantor: AMN.

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Correspondence to Ashish M. Narang.

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Narang, A.M., Pandey, A.A. & Bhat, M. Management of Severely Displaced Radial Neck Fractures in Children: A Systematic Review and Meta-analysis of Outcomes. JOIO 54, 60–68 (2020). https://doi.org/10.1007/s43465-019-00032-2

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  • DOI: https://doi.org/10.1007/s43465-019-00032-2

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