Arthrogram assisted reduction of radial neck fracture in a child with unossified radial head – A case report and review of literature |
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| Institution: | 1. Department of Orthopaedics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India;2. Department of Orthopaedics, GMCH 32, Chandigarh, India;3. Department of Orthopaedics, AIIMS, New Delhi, India;1. Department of Paediatric Orthopaedics, King George''s Medical University, Lucknow, Uttar Pradesh, India;2. Department of Orthopaedics, B.P. Koirala Institute of Health Sciences, Dharan, Nepal;3. Department of Orthopaedics, AIIMS, Patna, Bihar, India;1. Scottish National Spine Deformity Centre, Royal Hospital for Sick Children, Edinburgh, UK;2. Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Sick Children, Edinburgh, UK;1. Department of Orthopedic Surgery, Nationwide Children''s Hospital, Columbus, OH, USA;2. Department of Orthopedic Surgery, Doctor''s Hospital, Columbus, OH, USA;3. Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA;1. Department of Orthopedic Surgery, Nationwide Children''s Hospital, Columbus, OH, United States;2. Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, United States;1. East Midlands, UK;2. University Hospitals, Leicester, UK |
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| Abstract: | Radial neck fractures account for 1% of all paediatric fractures and constitute 5–10% of elbow injuries. Radial neck fractures rarely occur at age 2 or less. It is difficult to assess and reduce radial neck fractures in children with unossified radial head. We report a case of 2 years old female child presented to emergency with history of fall from stairs on an outstretched hand. Radiograph showed a metaphyseal spike in the proximal radius which prompted us to think of a radial neck fracture. Since the radial head was not ossified, the amount of displacement and angulation was not exactly quantifiable on radiographs only. Hence an arthrogram was planned. Intra operative use of radio opaque dye injection into elbow joint delineates the radial head and capitellum. It helps in identifying the fracture morphology and will also assist in reduction. We reduce radial head by K wire leverage technique and the intramedullary elastic titanium nail was added to assist in reduction and to improve fixation stability. We recommend arthrogram to be a safe and reliable option for proper assessment and reduction of radial neck fracture in an unossified radial head. |
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| Keywords: | Arthrogram Unossified radial head |
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