To propose a new method for evaluating paediatric radial neck fractures and improve the accuracy of fracture angulation measurement, particularly in younger children, and thereby facilitate planning treatment in this population. Clinical data of 117 children with radial neck fractures in our hospital from August 2014 to March 2023 were collected. A total of 50 children (26 males, 24 females, mean age 7.6 years (2 to 13)) met the inclusion criteria and were analyzed. Cases were excluded for the following reasons: Judet grade I and Judet grade IVb (> 85° angulation) classification; poor radiograph image quality; incomplete clinical information; sagittal plane angulation; severe displacement of the ulna fracture; and Monteggia fractures. For each patient, standard elbow anteroposterior (AP) view radiographs and corresponding CT images were acquired. On radiographs, Angle P (complementary to the angle between the long axis of the radial head and the line perpendicular to the physis), Angle S (complementary to the angle between the long axis of the radial head and the midline through the proximal radial shaft), and Angle U (between the long axis of the radial head and the straight line from the distal tip of the capitellum to the coronoid process) were identified as candidates approximating the true coronal plane angulation of radial neck fractures. On the coronal plane of the CT scan, the angulation of radial neck fractures (CTa) was measured and served as the reference standard for measurement. Inter- and intraobserver reliabilities were assessed by Kappa statistics and intraclass correlation coefficient (ICC).Aims
Methods
We retrospectively evaluated the clinical and
radiological outcomes of a consecutive cohort of patients aged >
70 years with a displaced fracture of the olecranon, which was treated
non-operatively with early mobilisation. We identified 28 such patients
(27 women) with a mean age of 82 years (71 to 91). The elbow was
initially immobilised in an above elbow cast in 90° of flexion of
the elbow for a mean of five days. The cast was then replaced by
a sling. Active mobilisation was encouraged as tolerated. No formal
rehabilitation was undertaken. At a mean follow-up of 16 months
(12 to 26), the mean ranges of flexion and extension were 140° and
15° respectively. On a visual analogue scale of 1 (no pain) to 10,
the mean pain score was 1 (0 to 8). Of the original 28 patients
22 developed nonunion, but no patients required surgical treatment. We conclude that non-operative functional treatment of displaced
olecranon fractures in the elderly gives good results and a high
rate of satisfaction. Cite this article:
