Successful Closed Reduction of a Jeffery Type 2 Radial Head Epiphysiolysis -A Case Report with Literature Review.

Introduction: Radial neck fractures in children are rare injuries, accounting for approximately 5-8.5% of all pediatric elbow fractures; even rarer is the Jeffery type 2 injury, which was described by Jeffery in 1950 and occurs during the automatic reduction of a previous posterior elbow subluxation or dislocation. Only few cases and case small series have been reported on this rare injury, but there is no report on the achievement of closed reduction of the radial head. In all the reported cases, open surgery was essential to achieve adequate reduction of the fracture, except for two cases where percutaneous reduction was achieved using a pin.

Case Report: We present a 10-year-old female patient with a Jeffery type 2 fracture who was treated successfully with closed reduction. We describe a detailed closed reduction method to treat the fracture, providing a brief literature review for this rare injury. The clinical outcome of our patient was excellent without any complications.

Conclusion: Jeffery's type 2 injury is a rare, but potential devastating lesion of the elbow, especially if left undiagnosed or inadequately treated. Adequate knowledge of the mechanism and presentation of the injury is mandatory for early diagnosis. Closed or percutaneous reduction is not only difficult but also preferable due to better functional outcomes. Awareness is needed to recognize early complications ("upside-down" radial head) after the external manipulation.