A Case Report of Bilateral Epiphyseolysis of Radial Neck in a Child

Abstract

We treated a case of bilateral epiphyseolysis of the radial neck in a child. She was injured when she landed with her arms outstreched while practicing handspring, resulting in a pronation and flexion of the elbows. At the time of impact, her elbows were forced into valgus slightly, compressing the surface of the radial head and fracturing the proximal end of the ulna.
Angulation of the right radial head was 70 degrees, and that of the left was 85 degrees. The case was classified as the severe group described by O'Brien (O'Brien type III).
Closed manipulation was not successful, so we treated her by the percutaneous leverage method under general anesthesia. Many complications by open reduction such as limitation of the elbow and forearm movement, avascular necrosis and pseudoarthrosis were reported. On the other hand this method was demonstrated to be extremely useful and easy.
Depression of the epiphysis over 60 degrees, as seen in this case, move or less requires some dislocation, thereby resulting in early closure of the epiphysis in most cases. The degree of valgus also depends on the remaining growth of the radius. It is concluded that the treatment of this epiphyseolysis should be by the closed method whenever possible. Internal fixation is seldom necessary and has its complications.