PMC6742868_01
Anteroposterior and lateral radiogram of the right elbow demonstrate the Jeffery type 2 injury.
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F1
Initial plain radiographs revealed a displaced radial head lying at a position of 90 degrees perpendicular to the posterior radius shaft, with capitellum interpositioning (Fig. 1).
Maneuver image description. One surgeon pushes the arm toward, while the second surgeon pulls the forearm downward and posterior to reproduce the elbow subluxation and achieve mild distraction (black arrows) of the joint. These two surgeons apply also a mild varus deformity (blue arrow). The main surgeon performs the milking maneuver (red arrow) to achieve the reduction.
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F2
The senior surgeon, using the "milking" maneuver, attempted to reduce the fracture (Fig. 2).
Anteroposterior and lateral radiogram of the right elbow demonstrate the successful closed reduction.
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F3
Then, he gently reduced the posterior subluxation and a splint was applied, with the elbow at a 90 flexion angle and the forearm in a neutral position (Fig. 3).
Anteroposterior and lateral radiogram of the right elbow demonstrate the maintenance of the reduction after 3 weeks of immobilization.
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F4
The plaster was removed 3 weeks later and, based on the excellent radiographic images, mobilization was initiated (Fig. 4).
Clinical images of the right elbow 3-month post-traumatic demonstrate full extension and 136 flexion.
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F5
At the 3-month follow-up, our patient had regained the full range of elbow (arc: 0-136 ) and forearm (arc of supination-pronation: 0-175 ) motion (Figs. 5 and 6).
Clinical images of both forearms 3-month post-traumatic demonstrate full recovery of supination-pronation.
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F6
At the 3-month follow-up, our patient had regained the full range of elbow (arc: 0-136 ) and forearm (arc of supination-pronation: 0-175 ) motion (Figs. 5 and 6).
Anteroposterior and lateral radiogram 1-year post-traumatic of both elbows demonstrate the 2  valgus deformity to the right elbow and the premature closure of the epiphysis.
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F7
At the last follow-up 12 months later, radiographs revealed premature closure of the upper radial epiphysis with 2  valgus deformity of the elbow comparatively to the contralateral elbow (Fig. 7), with no clinical impact to the patient (Fig. 8).