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Treatment of chronic isolated radial head dislocation in children
1Department of Pediatric Orthopedic Surgery, AZK-VUB, Brussels, Belgium.
Insights
Annular ligament reconstruction is unnecessary for chronic acquired isolated radial head dislocation in children. Simple open reduction and fixation with a transarticular pin provides excellent functional and radiographic outcomes.
Area of Science:
- Pediatric Orthopedics
- Musculoskeletal Surgery
Background:
- Chronic acquired isolated dislocation of the radial head is a rare condition in children.
- Previous treatments often involved complex procedures, including annular ligament reconstruction.
Purpose of the Study:
- To evaluate the efficacy of operative reduction without annular ligament reconstruction for chronic acquired isolated radial head dislocation in pediatric patients.
- To determine if annular ligament reconstruction is necessary for successful outcomes.
Main Methods:
- A retrospective case series of four children (1 girl, 3 boys; average age 7.1 years) with chronic acquired isolated radial head dislocation.
- All patients underwent simple open reduction and fixation with a transarticular pin for 6 weeks.
- Clinical and radiographic assessments were performed with an average follow-up of 50.7 months.
Main Results:
- All four patients achieved excellent postoperative functional and radiographic outcomes.
- Significant improvements in elbow range of motion were observed in all patients.
- No complications or need for revision surgery were reported.
Conclusions:
- Operative reduction without annular ligament reconstruction is a safe and effective treatment for chronic acquired isolated radial head dislocation in children.
- Annular ligament reconstruction appears unnecessary, simplifying the surgical approach.
- Simple open reduction and fixation with a transarticular pin is a viable treatment option.
Abstract:
Four children had an operative reduction without annular ligament reconstruction for chronic acquired isolated dislocation of the radial head: one girl and three boys with an average age of 7.1 years (range, 4-8.5 years). History indicated that all children had sustained an injury. Results, with an average followup of 50.7 months, were assessed clinically and radiographically. All patients had excellent postoperative functional and radiographic outcomes. Measurements of range of motion of the elbow revealed improved motion in all patients. Reconstruction of the annular ligament seems unnecessary and, therefore, it is suggested that an unreduced radial head dislocation can be treated by simple open reduction and fixation for 6 weeks with a transarticular pin.