New reduction technique for severely displaced pediatric radial neck fractures.

This study describes a new maneuver to assist in the closed reduction of severely displaced (angulated >60 degrees) pediatric radial neck fractures. Four patients with displaced radial neck fractures were identified prospectively when attempts at reduction in the emergency department failed. The new reduction maneuver was performed in the operating room with the patient under general anesthesia. All fractures were reduced to near-anatomic position, and all fractures were followed to union. No reduction was lost. The authors conclude that the proposed reduction technique can be of assistance in the nonoperative management of these fractures. The authors also recommend that all attempts at reduction of these severely displaced fractures be performed with the patient under general anesthesia.