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In retrospect, 56% were visible, and 44% radiographically occult. A retrospective study of 494 proximal radius fractures showed that 25% of the concomitant fractures were missed on the initial analysis of radiographs. Adequate follow-up is therefore warranted.Ī concomitant fracture is seen in up to 39% of cases. However, severe complications do occur, including radio-ulnar synostosis, osteonecrosis, rotational impairment, and premature physeal closure with a malformation of the radial head as a result, especially after more invasive procedures. With proper management, good to excellent results are achieved in most cases, and long-term sequelae are rare. Fractures with limited displacement and non-surgical treatment generally result in superior outcomes in terms of patient-reported outcome measures, range of motion and complications compared to severely displaced fractures requiring surgical intervention. The choice of treatment depends on the degree of angulation and displacement of the fracture and the age of the patient an angulation of less than 30 degrees and translation of less than 50% is generally accepted, whereas a higher degree of displacement is considered an indication for surgical intervention. The treatment options for proximal radius fractures in children range from non-surgical treatment, such as immobilization alone and closed reduction followed by immobilization, to more invasive options, including closed reduction with percutaneous pinning and open reduction with internal fixation. In up to 39% of proximal radius fractures, there is a concomitant fracture, which can easily be overlooked on the initial standard radiographs. Radial head and neck fractures represent up to 14% of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient.