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Radial Neck Fracture

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Radial head should point at capitellum in all views.

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  • Uncommon

  • 8% paediatric elbow fractures

  • Median age 9-10 years

  • 50% have other associated elbow injuries

    • Avulsion medial epicondyle

    • Fracture Proximal Ulna

    • Fracture Olecranon

MECHANISM:

FOOSH with Valgus stress at elbow.

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ORTHO If:

  • >10 years old

  • >30 degree angulation or 3mm translation.

  • Intra-articular physeal fracture (Salter Harris III and IV)

  • Associated injuries in the same limb

  • Extreme swelling/compartment syndrome

  • Open fracture

  • Neurovascular injury

MANAGEMENT

  • Analgesia

  • Fractures with <=30 degree angulation and <3mm translation do not require reduction.

    • Above elbow backslab​ with elbow in 90 degree flexion.

  • Older children less angulation is acceptable.  If >10 years old discuss with Ortho.

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