Outcome of intramedullary pinning of isolated radial neck fractures in adulthood

Background: The treatment of radial neck fractures is controversial and typically depends on displacement. Surgical procedures based on open reduction-internal fixation (ORIF) may lead to several complications, such as avascular necrosis of the radial head, nonunion, malunion and elbow stiffness. Closed reduction with intramedullary pinning of radial neck fractures, which is commonly used in children, is a viable option for these fractures in adults and may allow for a lower complication rate compared with ORIF. The aim of this study was to report the functional outcome of closed reduction and intramedullary stabilization in isolated radial neck fractures. Methods: Fourteen cases were retrospectively reviewed between January 2007 and December 2016. The inclusion criteria were isolated radial neck fractures of type I to III according to the Mason classification, absence of previous injuries of the elbow, and a minimum of 1 year of follow-up. The Mason classification was used to classify these injuries. At final follow-up, functional assessment was established based on functional scores: Morrey Elbow Score, Elbow Self-Assessment Score, and QuickDASH (short version of Disabilities of the Arm, Shoulder and Hand questionnaire) score. Range of motion was evaluated similarly. Results: The mean follow-up period was 86 months. The mean age was 44.2 years. Regarding the functional outcome, 78% of patients claimed satisfaction. Concerning the functional scoring, the mean visual analog scale score was 0.2 (range, 0-4) and the mean Morrey Elbow Score was 95.7 (range, 85-100). The mean Quick DASH score was 6.4 (range, 7-22). The complication rate was 35%. Malunion was observed in 7% of patients. Conclusion: Intramedullary pinning of radial neck fractures represents a viable technique in adults because of its safety and simplicity. The complication rates are lower than those in other reports of ORIF. (C) 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.