Radial neck fractures in children secondary to horse-riding accidents: a comparative study

Introduction In the pediatric population, fractures of the radial neck account for approximately 1% of all fractures and can have substantial consequences. Given the growing popularity of horse riding and the high-energy traumas that this can entail, we sought to assess prognosis for radial neck fracture sustained in horse riding. Hypothesis Radial neck fracture sustained in horse riding is more severe and more frequently associated with other ipsilateral osteoarticular lesions which worsen prognosis. Material and method We performed a multicenter retrospective comparative study in a continuous series of 39 patients. The inclusion criteria consisted of radius neck fracture in children under the age of 15 years. Endpoints comprised associated lesions at time of trauma, and ranges of elbow motion in pronation/supination and flexion/extension at last follow-up. Results Compared to other etiologies, radial neck fractures following horse-riding accidents were more frequently associated with other ipsilateral osteoarticular lesions (p = 0.0002), and more often required open reduction (p = 0.0409) and postoperative rehabilitation (p = 0.041). However, there were no significant differences in any ranges of motion at last follow-up (p > 0.05). Conclusion Radial neck fractures following horse-riding accidents in children were more severe than those caused by other mechanisms. Awareness campaigns in riding clubs and development of specific protective equipment should be considered to reduce occurrence. Level of evidence Therapeutic III – Retrospective comparative study.