1、1Radial Neck Fracturesin Children Treated With ElasticStable Intramedullary NailingNingbo No. 6 hospital Caojin 2Anatomy 3Characteristic begins at four years and it fuses at the age of 14 in females and 17 in males.Ossification center4Characteristic age 414years disease rate: 5% of elbow injuriesor
2、1% of all injuries in chindren 5Mechanism Elbow in extension :more common typeElbow in flexed:rare type67D Wilkins E history symptom physical sign radiograph10Reduction vClosed reductionvPercutaneous pin reductionvOpen recuction11Closed reduction30 606012Percutaneous pin reduction Risk :radial nerve
3、 injury13Open reduction controversial outcomes incidence of complication causes additional damage open reduction1415Tecnique of elastic nailing1617Postoperative radiograph18Case 1 A 6-year-old boy sustained a Judet type IV fracture of the radial neck. Follow-up radiograph after elastic nailing shows
4、 good reduction.The patient had an excellent outcome.19Case 1 Follow-up radiograph shows fracture union and anatomic reduction.The patient showed an excellent clinical result and resumed full motion.202122Case 2 10-year-old boy sustained a Judet type IV fracture of the radial neck.23 Postoperative r
5、adiograph shows anatomic reduction.The patient showed a minimal incision.24252627Anatomy By four years of age, the radial head and neck have assumed their adult shape with a physiological angulation of the neck in the anteroposterior (AP) plane of an average of 12.5 laterally and in the lateral plan
6、e of an average of 3.5 anteriorly. The proximal radial epiphysis is mainly supplied by periosteal blood vessels running from distal to proximal.28Mechanism 2 main mechanisms of injury were described in literature. In the more common type, a radial neck fracture occurs after a fall with the elbow in
7、extension and valgus, resulting in a fracture with valgus angulation. In the rare type, the mechanism is a fall with the elbow flexed, which causes temporary and posterior dislocation of the elbow joint.30Reduction vThe severely angulated fractures can be treated with closed reduction, percutaneous
8、reduction, and open Reduction.31Open reduction open reduction is controversial.Traditionally, it was performed if closed manipulation failed. in general, outcomes after open reduction are worse than those obtained after closed reduction. after open reduction, the incidence of complication , is highe
9、r than those after closed reduction. open reduction causes additional damage to the soft tissue, with fibrous adhesions and loss of range of motion. Some radial neck fractures are impossible to reduce with closed methods, requiring open reduction32 结束语当你尽了自己的最大努力时，失败也是伟大的，所以不要放弃，坚持就是正确的。When You Do Your Best, Failure Is Great, So DonT Give Up, Stick To The End33谢谢大家荣幸这一路，与你同行ItS An Honor To Walk With You All The Way演讲人：XXXXXX 时 间：XX年XX月XX日
