Preoperative Plan

Planning remarks:  In light of recent literature, the Métaizeau technique has established itself as an effective, minimally invasive surgical intervention for paediatric radial neck fractures. Judet classification forms a foundation for therapeutic decision-making with type III-IV fractures demonstrating a clear surgical indication for this method. The operative plan commences with the reduction under fluoroscopy control, ensuring a thorough evaluation of the alignment and rotation of the fracture fragments. A closed reduction and internal fixation with elastic intramedullary nailing is then implemented, which forms the crux of the Métaizeau technique. This step necessitates the insertion of the nail in a retrograde fashion, and is dependant on the stability of the elbow joint to hold the radial head in position during insertion. In order to augment stability, a surgical tip would be to incorporate percutaneous K-wire fixation in conjunction with the Métaizeau technique. The results of this method are corroborated by a retrospective analysis of 21 patients who demonstrated favourable outcomes. In comparison to alternative methods such as percutaneous joystick reduction with Kirschner wires and open reduction with or without internal fixation, the Métaizeau technique has consistently yielded superior results. The evidence-based therapy recommendation for a Judet type IV PRNF is, therefore, the Métaizeau technique, supplemented with percutaneous K-wire fixation for enhanced stability as required. This recommendation is supported by a number of studies, advocating its efficacy and outcomes, particularly in maintaining the integrity of soft tissue.