Functional Outcomes After Closed Reduction and Percutaneous K-Wire Fixation for Isolated Pediatric Radial Neck Fractures: An Exploratory Analysis of Associated Factors

Aim: To characterize final functional outcomes and explore demographic, fracture-related, and treatment-related correlates of side-to-side elbow motion loss after closed reduction and percutaneous pinning (CRPP) of isolated pediatric radial neck fractures.Material and Methods: This single-center retrospective cohort included 37 patients younger than 16 years with isolated Judet type III–IVb radial neck fractures treated with CRPP between January 2015 and January 2025. Outcomes assessed after at least 12 months were the contralateral-minus-affected flexion–extension and pronation–supination arc loss and the Mayo Elbow Performance Score (MEPS). Associations with candidate variables were examined using Spearman rank correlations with Benjamini–Hochberg correction for multiple testing.Results: Median follow-up was 41 months (IQR, 38–52 months). Mean flexion–extension and pronation–supination arc losses were 3.8 ± 2.1° and 4.3 ± 2.0°, respectively, and median MEPS was 100 (IQR, 95–100). Four patients (10.8%) experienced a complication. Greater pronation–supination arc loss correlated with older age, greater initial maximum angulation, and greater initial maximum displacement (ρ = 0.609, 0.611, and 0.608, respectively; all q < 0.001). No other association met the multiplicity-adjusted significance threshold.Conclusion: Among patients with isolated radial neck fractures treated using CRPP without conversion to open reduction, final elbow function was favorable and mean side-to-side motion losses were small. Older age and greater initial fracture deformity correlated with greater pronation–supination loss; however, their clinical importance and independent prognostic value remain uncertain.