Bilateral Radial Neck Fractures in a Child Report of a Case O ¨ zkan Ko ¨se, MD, Bahtiyar Demiralp, MD, and Mahmut Ko ¨mu ¨rcu ¨, MD Abstract: Fractures of the proximal radius are among the most common fractures and account for 9% to 25% of the elbow fractures in children. However, bilateral radial neck fractures are extremely rare injuries in children and have been reported only once before in present English literature. We report a case of bilateral radial neck fractures in a 10-year-old girl resulting from a fall on outstretched hands. Careful physical examination and proper radiographs are necessary for the diagnosis. Early recognition, proper management, and physical therapy led to complete recovery and full functional movement of the elbows. Key Words: radial fractures R adial head and neck fractures comprise 9% to 25% of all fractures around the elbow in children. 1Y3 However, bilateral radial neck fractures are extremely rare injuries in children. Although there are a few cases in adults, we have identified only 1 case in a child, which has been reported by Kay and Kuschner 4 previously in the English literature. 5Y8 We report a case of bilateral radial neck fractures in a 10- year-old girl who sustained this rare injury because of a fall on outstreched hands. Conservative treatment resulted in an excellent clinical outcome. CASE A 10-year-old girl presented to the emergency department after falling off the stairs and landing on both forearms with outstreched hands. She complained of pain and limited elbow motion bilaterally, right greater than left. On physical examina- tion, she had tenderness over the radial heads with slight ef- fusions at the elbows and pain on rotational movements. Neurovascular examination was intact bilaterally. Anteroposterior (AP) and lateral radiographs of both elbows were obtained. An additional oblique view of the right elbow was further performed because of doubt of fracture. Bilateral nondisplaced Salter-Harris type II radial neck fractures were identified finally (Fig. 1). Above-elbow soft casts were applied for 2 weeks after which the child received 2 weeks of physiotherapy. At the final follow-up 3 months after the initial injury, the patient gained full range of elbow motion and rotation without pain. FIGURE 1. Radiographs on initial presentation demonstrated a visible left radial neck fracture and a questionable fracture of the right proximal radius. An additional oblique view of the right elbow revealed the fracture line. Illustrative Case Pediatric Emergency Care  Volume 24, Number 7, July 2008 464 Department of Orthopaedics and Traumatology, Gu ¨lhane Military Medical Academy, Ankara, Turkey. Address correspondence and reprint requests to O ¨ zkan Ko ¨se, MD, Mumin- deresi cd. Belediye BloklarN 3. Blok Daire: 10 SahrayNcedit KadNko ¨y, Istanbul, Turkey. E-mail: drozkankose@hotmail.com. Copyright * 2008 by Lippincott Williams & Wilkins ISSN: 0749-5161/08/2407-0464 Copyright @ 2008 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.