Pediatric Proximal Radius Fracture and Reduction Techniques: An Educational Review

Pediatric radial neck fractures are rare, comprising about a tenth of all elbow injuries in children (1). They typically affect the children between 4 to 14 years of age with a peak of incidence ranging between 8 and 10 years of age (2). Because radial head ossification starts at age 5 and is completed when the physis closes at 14 years of age for boys and 17 for girls (3). The most common mechanism of this fracture is falling over an outstretched extended hand with a valgus force (4). The most common radial neck fractures are extra-physeal fractures of the metaphysis or Salter-Harris I or II fractures of the proximal radial physis (4). Closed fractures are more common than open ones and near half of these fractures are associated with the ipsilateral elbow dislocation, olecranon fractures, and ruptured collateral ligaments (5). The classification systems in radial neck fractures including the Jeffery, O’Brien, and Judet and Letournel classification systems are the most commonly cited ones in the literature (3).