Functional Outcomes After Closed Reduction and Percutaneous K-Wire Fixation for Isolated Pediatric Radial Neck Fractures: An Exploratory Analysis of Associated Factors
Abstract
Aim: To characterize final functional outcomes and explore demographic, fracture-related, and treatment-related correlates of side-to-side elbow motion loss after closed reduction and percutaneous pinning (CRPP) of isolated pediatric radial neck fractures.
Material and Methods: This single-center retrospective cohort included 37 patients younger than 16 years with isolated Judet type III–IVb radial neck fractures treated with CRPP between January 2015 and January 2025. Outcomes assessed after at least 12 months were the contralateral-minus-affected flexion–extension and pronation–supination arc loss and the Mayo Elbow Performance Score (MEPS). Associations with candidate variables were examined using Spearman rank correlations with Benjamini–Hochberg correction for multiple testing.
Results: Median follow-up was 41 months (IQR, 38–52 months). Mean flexion–extension and pronation–supination arc losses were 3.8 ± 2.1° and 4.3 ± 2.0°, respectively, and median MEPS was 100 (IQR, 95–100). Four patients (10.8%) experienced a complication. Greater pronation–supination arc loss correlated with older age, greater initial maximum angulation, and greater initial maximum displacement (ρ = 0.609, 0.611, and 0.608, respectively; all q < 0.001). No other association met the multiplicity-adjusted significance threshold.
Conclusion: Among patients with isolated radial neck fractures treated using CRPP without conversion to open reduction, final elbow function was favorable and mean side-to-side motion losses were small. Older age and greater initial fracture deformity correlated with greater pronation–supination loss; however, their clinical importance and independent prognostic value remain uncertain.
Keywords
References
- Langenberg LC, Benner JL, Bernal Bader N, van Bergen CJA, Colaris JW. The presence of associated injuries in pediatric radial neck fractures: a systematic review of the literature and meta-analysis of pooled individual patient data. Children (Basel). 2025;12(3):300. doi:10.3390/children12030300.
- Langenberg LC, van den Ende KIM, Reijman M, Boersen GJJ, Colaris JW. Pediatric radial neck fractures: a systematic review regarding the influence of fracture treatment on elbow function. Children (Basel). 2022;9(7):1049. doi:10.3390/children9071049.
- Zimmerman RM, Kalish LA, Hresko MT, Waters PM, Bae DS. Surgical Management of Pediatric Radial Neck Fractures. J Bone Joint Surg Am. 2013;95(20):1825-32. doi:10.2106/JBJS.L.01130.
- Yang L, Yang X, Zuo J, Wang D, Li L, Tang X. A retrospective review of 101 operatively treated radial neck fractures in children and analysis of risk factors for functional outcomes. Injury. 2022;53(10):3310-6. doi:10.1016/j.injury.2022.07.016.
- Zuo J, Jiang J, Yang X, Zou L, Tang X, Yang L. Predictive factors for open reduction of operatively treated radial neck fractures in children. Injury. 2023;54(12):111169. doi:10.1016/j.injury.2023.111169.
- Kalem M, Şahin E, Kocaoğlu H, Başarır K, Kınık H. Comparison of two closed surgical techniques at isolated pediatric radial neck fractures. Injury. 2018;49(3):618-23. doi:10.1016/j.injury.2018.01.012.
- Massetti D, Marinelli M, Facco G, Falcioni D, Giampaolini N, Specchia N, et al. Percutaneous k-wire leverage reduction and retrograde transphyseal k-wire fixation of angulated radial neck fractures in children. Eur J Orthop Surg Traumatol. 2020;30(5):931-7. doi:10.1007/s00590-020-02654-x.
- Guzikiewicz N, Małecki K, Sibiński M, Niedzielski K. Clinical and radiological evaluation of radial neck factures in children and adolescents treated by percutaneous leverage reduction with Kirschner wire stabilization. Int Orthop. 2024;48(6):1463-9. doi:10.1007/s00264-023-05965-w.
Details
Primary Language
English
Subjects
Health Services and Systems (Other)
Journal Section
Research Article
Publication Date
October 27, 2026
Submission Date
August 8, 2026
Acceptance Date
October 13, 2026
Published in Issue
Year 2026 Volume: 18 Number: 3


