S. Sessa et al., FRACTURES OF THE RADIAL HEAD AND ASSOCIATED ELBOW INJURIES IN CHILDREN, Journal of pediatric orthopedics. Part B, 5(3), 1996, pp. 200-209
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.