Ultrasound-assisted closed reduction for O'Brien type Ⅱ and Ⅲ radial neck fractures in chil-dren

Song Zhijie; Peng Lixing; Shen Jie; Gu Yunyu; Liang Zhuying

doi:10.3969/j.issn.1009-4237.2025.01.008

Abstract：Objective To introduce an ultrasound-assisted closed reduction technique and evaluate its ef-fectiveness in the treatment of pediatric radial neck fractures of O'Brien types Ⅱ and Ⅲ.Methods A retrospec-tive analysis was carried out on the data of 30 children with O'Brien type Ⅱ and Ⅲ radial neck fractures who un-derwent emergency trauma surgery at Kunming Children's Hospital from Aug.2020 to Aug.2022.There were 19 males and 11 females aged 4-12(mean 8.6)years.Thirteen cases involved the left side and 17 the right.All of them were injured due to falls.According to O'Brien's classification,12 cases were of type Ⅱ and 18 of type Ⅲ.All the 30 cases underwent ultrasound-assisted closed reduction and elastic intramedullary nail fixation.Demograph-ic and clinical data,including age,gender,surgery time,fracture healing time,and complications,were analyzed.Postoperative data were evaluated based on the Metaizeau evaluation criteria to assess the reduction effect,as well as complications to judge the surgical efficacy.Results The ultrasound-assisted closed reduction was successfully conducted on all the 30 cases,with the surgery time being(31.0±4.6)min and fracture healing time(5.0±1.0)weeks.The Metaizeau technique indicated excellent results in 28 cases,and good results in 2 cases,without any ra-dial head necrosis,nerve injury,or epiphyseal premature closure.One case had needle tail irritation,which achieved good healing at outpatient follow-up after removal of the internal fixation.Conclusion Ultrasound,as a non-invasive and reproducible technique,can assist in the reduction of radial neck fractures in children.It not only shows satis-factory surgical results but also has the advantages of minimal invasion and simple surgical operations.