Management of chronic posttraumatic radial head dislocation in children

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Traumatology

Background:

• Chronic posttraumatic radial head dislocation presents a management challenge, particularly in pediatric patients.
• Existing treatments may not adequately address annular ligament integrity and radial head stability.

Observation:

• A new surgical procedure utilizing two drill holes in the proximal ulna was developed and refined.
• This technique allows for direct repair or reconstruction of the annular ligament at its original attachments.
• The procedure accommodates osteotomy for concurrent deformities of the ulna or radius.

Findings:

• Seven female patients with chronic posttraumatic radial head dislocation were treated.
• Surgical criteria included a normal concave proximal radial articular surface and normal ulna/radius contour.
• All patients achieved full activity with no elbow pain or instability post-operatively, regardless of age or dislocation duration.

Implications:

• This technique offers a reliable solution for chronic posttraumatic radial head dislocation, particularly in children.
• The procedure's success suggests that the radial head's articular surface and bone alignment are key surgical indicators.
• Age and duration of dislocation are less critical factors than the joint's structural integrity for successful surgical outcomes.