From the Research
The Metaizeau technique of retrograde intramedullary pinning is the gold standard for treating displaced radial neck fractures in pediatric patients, as it offers minimal soft tissue disruption, preservation of the blood supply to the radial head, reduced risk of avascular necrosis, and excellent functional outcomes, as demonstrated in a study published in 2024 in the Journal of Bone and Joint Surgery Essential Surgical Techniques 1.
Key Points
- The Metaizeau technique involves the insertion of a K-wire or elastic stable intramedullary nail through the distal radius, which is then advanced proximally to engage and reduce the radial head fragment.
- The procedure typically requires fluoroscopic guidance to ensure proper placement and reduction.
- Post-operatively, patients usually require immobilization in a long arm cast for 4 to 6 weeks, followed by progressive range of motion exercises.
- Complications are relatively rare but may include pin migration, growth disturbance, or inadequate reduction.
- The Metaizeau technique has demonstrated superior outcomes compared to open reduction methods, particularly for Judet type III and IV fractures with angulation greater than 30 degrees, as reported in studies published in 2024 1, 2016 2, and 2012 3.
Advantages of the Metaizeau Technique
- Minimal soft tissue disruption
- Preservation of the blood supply to the radial head
- Reduced risk of avascular necrosis
- Excellent functional outcomes
- Low complication rate
Indications for the Metaizeau Technique
- Displaced radial neck fractures in pediatric patients
- Judet type III and IV fractures with angulation greater than 30 degrees
- Fractures with intact periosteum
Contraindications for the Metaizeau Technique
- Open fractures
- Fractures with significant soft tissue damage
- Fractures with compromised blood supply to the radial head
- Fractures with associated elbow instability or dislocation, as reported in a study published in 2014 4