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Chronic radial head dislocation in children, Part 1: pathologic changes preventing stable reduction and surgical
Hui Taek Kim1, Jesse Noel V Conjares, Jeung Tak Suh
1Pediatric Orthopaedic Unit, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan, Korea. kimht@hyowon.pusan.ac.kr
Journal of Pediatric Orthopedics
|August 29, 2002
Summary
Delayed treatment of pediatric radial head dislocation can cause significant elbow deformities. Open reduction and correction of dysplastic changes are essential for restoring elbow function and congruency.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Pediatric Traumatology
Background:
- Radial head dislocation in children, whether congenital or posttraumatic, can lead to significant pathologic changes if unreduced.
- These changes include dysplastic alterations in the radial head and neck, and ulnar bowing, impacting elbow function.
Purpose of the Study:
- To review the pathologic changes associated with long-standing radial head dislocation in children.
- To evaluate the outcomes of open treatment aimed at restoring elbow joint congruency and function.
Main Methods:
- Retrospective review of 15 elbows in 14 children with radial head dislocation unreduced for at least 3 months.
- Analysis of common dysplastic changes and correlation with delay in treatment for traumatic cases.
- Assessment of open reduction procedures focusing on joint congruency and correction of deformities.
Main Results:
- Common findings included deformed radial heads, slender radial necks, and ulnar bowing, observed in both congenital and posttraumatic dislocations.
- More severe deformities in traumatic cases correlated with longer delays from injury to reduction.
- Persistent pain, limited motion, and deformity were key indications for surgical intervention.
Conclusions:
- Restoration of capitello-radioulnar joint congruency and correction of dysplastic changes are mandatory for successful open reduction.
- Surgical intervention is necessary to address unacceptable symptoms and improve rotational arc and stability in pediatric radial head dislocations.