Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Abstract
Paediatric radial neck fractures accounts for 1 % of all fractures and 5‐10 % of all traumatic lesions involving paediatric elbow. Close and open reduction is challenging in Judet type III and IV, paediatric radial neck fractures and if not managed accurately leads to poor outcome. Retrograde intramedullary percutaneous nail reduction known as Metaizeau technique is considered most effective technique for displaced radial neck fracture, allowing early range of motion thus achieving excellent functional outcome. Aim of this study is to evaluate anatomical and functional outcome of Metaizeau technique and surgical tips to improve stability of fixation in paediatric radial neck fractures. This prospective study includes 20 paediatric radial neck fractures of Judet type III and IV, 15 males, 5 females, which were managed with Metaizeau technique. Clinical evaluation was done using Metaizeau classification, subjective evaluation done using DASH score, radiological evaluation done using steel’s classification with follow up period of 12 weeks. 20 patients were treated with this Metaizeau technique, ranging from 8‐13 years, 16 patients (80%) are type III, 3 patients (15%) are type IVa and 1 patient (5%) is type IVb, according to Judet classification. 14 patients (70%) had closed reduction, in 4 patients (20%) lever arm technique was used and 2 patients (10%) had open reduction. Clinical examination revealed excellent axis in all patients, with mean DASH score of 2.72%. The ROM examination according to Metaizeau, revealed perfect in 14 patients (70%), good in 4 patients (20%), acceptable in 1 patient (5 %), and bad result in 1 patient (5%). Radiological examination according to Ursei, revealed, 15 patients (75%) healed in anatomical position with perfect result, 3 patients (15%) having good results, healed with posterior angulation of 15°, 18° and 10°, 1 patient (5%) healed with malunion and 1 patient (5%) had bad result with pseudoarthrosis. One patient that undergone open reduction had developed pseudoarthrosis having bad clinical outcome. The technique of Metaizeau is closed, minimally invasive, elastic stable intramedullary nailing technique with extraarticular manipulation, is now considered gold standard for paediatric displaced radial neck fracture, yield good to excellent results in paediatric age group in Judet type III and IV radial neck fracture with angulation. Results in our series are excellent. Increased fracture severity with open reduction is associated with poor results.
How to cite this article:
Nand Anmol Arpan, Gupta Vivek Kumar, Priyadarshi Swapnil and Ajmeriya Rohit. Centromedullary Metaizeau Technique for Displaced Paediatric Radial Neck Fracture: Surgical
Technique and Outcomes.
DOI: https://doi.org/10.36478/10.59218/makrjms.2023.9.14.21
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2023.9.14.21