Stability-guided treatment of pediatric radial neck fractures: percutaneous reduction with cast immobilization versus elastic intramedullary nailing

In this retrospective study, PKWLR-CI was associated with clinical outcomes that were comparable to those of PKWLR-EIMN for Metaizeau-Judet type II-IV fractures when intraoperative stability criteria are met. In this cohort, the selective use of PKWLR-CI avoided the need for implant removal surgeries and was associated with a 38% reduction in operative time and a 28% reduction in hospitalization costs, highlighting the critical role of periosteal hinge integrity in maintaining reduction.