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Morphologic evaluation of chronic radial head dislocation: three-dimensional and quantitative analyses.

Kunihiro Oka¹, Tsuyoshi Murase, Hisao Moritomo

¹Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan. oka-kunihiro@umin.ac.jp

Clinical Orthopaedics and Related Research

|March 6, 2010

Summary

Chronic radial head dislocation leads to significant changes in the proximal radioulnar joint over time. Longstanding dislocations cause deformation of the radial head and ulna, influencing treatment decisions.

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Area of Science:

Orthopedic surgery
Biomechanics
Radiology

Background:

Treatment for chronic radial head dislocation remains controversial, particularly regarding proximal radioulnar joint reconstruction.
Anatomical changes in chronic radial head dislocations that guide surgical decisions are not fully understood.

Purpose of the Study:

To investigate the specific changes in the proximal radioulnar joint associated with chronic radial head dislocations.
To determine how these anatomical alterations influence the decision-making process for surgical repair.

Main Methods:

A cohort of 15 patients with chronic radial head dislocations was divided into early (<3 years) and longstanding (>3 years) groups.
Three-dimensional (3-D) bone models from CT data were used to measure radial notch angle and depth, and assess radial head deformity.

Main Results:

No significant radial notch shape differences were found in the early dislocation group.
Longstanding dislocations showed increased radial notch angle and decreased depth, along with dome-shaped radial head deformity.

Conclusions:

Chronic radial head dislocations exceeding three years result in adaptive remodeling and deformation of the radial head and ulnar radial notch.
These deformities correlate with the chronic dislocated position of the radial head.