Radial Head/Neck Fractures

Question 1

Minimally displaced radial neck fractures can result in what dreaded complication?

Answer 1

Compartment syndrome

Question 2

Describe the Greenspan view of the radiocapitellar joint?

Answer 2

oblique lateral performed with forearm in neutral rotation and beam directed 45 degrees proximally

Question 3

What are operative reduction indications in pediatric radial neck fractures?

Answer 3

1) > 30° of residual angulation
2) 3-4 mm of translation
3) Less than 45° of pronation and supination

Question 4

What degree of angulation is acceptable in radial neck fractures in a pediatric patient?

Answer 4

Less than 30°;
if less than 30° angulation immobilize without closed reduction
if >30° angulation perform closed reduction and immobilize if angulation reduced to less than 30°
begin early ROM at 3-7 days to prevent stiffness

Question 5

What are common techniques of radial neck fracture reduction?

Answer 5

Patterson maneuver:
hold the elbow in extension and apply distal traction with the forearm supinated and pull the forearm into varus while applying direct pressure over the radial head

Israeli technique:
pronate the supinated forearm while the elbow is flexed to 90° and direct pressure stabilizes the radial head

elastic bandage technique:
tight application of an elastic bandage beginning at the wrist continuing over the forearm and elbow may lead to spontaneous reduction