FRACTURES OF THE RADIAL HEAD AND ASSOCIATED ELBOW INJURIES IN CHILDREN

Fractures of the radial head are frequently associated with elbow inju ries in children. Thirty-seven patients with this association treated at the Nancy Children's Hospital were analyzed to ascertain the mechan ism and the unfavorable factors of prognosis. The mechanism responsibl e was a valgus strain on the elbow at the moment of impact, associated with forces of compression and distraction. At an average follow-up o f 2 years, 76% excellent and good results were obtained. Conservative treatment was always effective in minimally displaced fractures. With surgical reduction by closed intramedullary pinning (CIMP), there were only three failures in severely displaced fractures. With open reduct ion, results were always poor; 88% patients with fair and poor results had an associated fracture of the olecranon. The unfavorable prognost ic factors were the severity of the initial tilting and displacement, the presence of associated elbow injuries, the inadequacy of reduction , and the open reduction procedure.