![]() Often diffuse and progressive, not resolved by analgesia, worsened by passive flexion of the injury. ![]() Untreated, this can lead to ischaemic injury within 4-8 hours.Īssessing for compartment syndrome – the 5 Ps Compartment syndrome is a limb-threatening condition caused by increased pressure within the closed space of a muscular compartment which causes compression of the nerves, muscles, and vessels within the compartment. Radial neck fractures can also be associated with compartment syndrome of the forearm, although thankfully this is rare. Having a second injury is associated with a poorer outcome. Any radial neck fractures with a second elbow injuryģ0-50% of children with a proximal radial fracture have another fracture – examine the child and their x-rays very carefully.Which children need to be discussed with the orthopaedic team before they go home? Those with displacement of >30 degrees tend to have a worse outcome and should be referred to orthopaedics as reduction, and possible internal fixation will be required. These do really well with conservative management with immobilization in a collar and cuff. Most paediatric radial neck fractures are type I: undisplaced or minimally displaced. How should radial neck fractures be managed? ![]() Other radial neck classifications have been described so, to avoid confusion, it’s probably safest to describe the degree of displacement rather than the classification type, especially as displacement of radial neck fractures in children is uncommon. O’Brien’s classification of radial neck fractures. Radial neck fractures were classified by O’Brien (1965) as follows: 2016 46:61-6 How are radial neck fractures classified? Reproduced with permission from Emery et al. Mildly angulated radial neck fracture (black arrow) and posterior fat pad (white arrow).
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