RESUMO
Fractures of the neck of the radius (Mason's type IV) are rarely seen in the adult although they are the most frequent in the child. There is no satisfactory treatment at the present time and the authors present 2 cases treated by intramedullary nailing with good results. This technique was described by Metaizeau and al for the child.The first case was a woman 46 years old presenting a dislocation of the left elbow with a radial neck fracture Mason's type IV. The angulation between the radial head and the diaphysis was 55°. The dislocation was spontaneously reduced and an intramedullary nailing was performed on the radial neck fracture. Six months later the mobility of the elbow was normal except 10° loss of extension. The X-rays showed a radial head with no evidence of necrosis, and no residual angulation.The second case is a 25-year-old man with a Mason's type IV radial neck fracture. The angulation was 50°. At 6 months of follow up the elbow still had 15° loss of extension. The X-rays appearances were the same that for the first case.The procedure is detailed. The entry point is at the distal metaphysis. A kirschner wire is curved at its extremity and pushed into the medullary canal. The radial head is pinned by the sharp curved extremity of the wire. A rotating motion of the wire allows reduction and fixation of the fracture.The authors experience and the 6 cases presented by Keller shows that intramedullary nailing seems a good solution for fixation of the radial neck fractures.
