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[Operative long-term results in delayed radius head dislocation in childhood]
Insights
Surgical reconstruction is effective for delayed radial head luxation in children, even years after injury. This approach can restore joint function and provide good outcomes, contrary to some existing literature.
Area of Science:
- Pediatric Orthopedics
- Traumatology
- Pediatric Surgery
Background:
- Delayed radial head luxation in children is infrequently reported with limited long-term follow-up.
- Existing literature offers minimal guidance on managing these complex pediatric orthopedic injuries.
Purpose of the Study:
- To evaluate the efficacy of surgical reconstruction for delayed radial head luxation in children.
- To present long-term outcomes of operative management for this rare pediatric condition.
Main Methods:
- Operative treatment of 21 children with delayed radial head luxation (average 12.5 months post-injury).
- Procedures included joint repositioning, annular ligament plasty, and corrective osteotomies (ulnar or radial shortening).
- Long-term follow-up (average 7.9 years) assessed functional and radiographic outcomes.
Main Results:
- Most patients achieved good or satisfactory results following surgical reconstruction.
- Reluxation occurred in 2 cases, subluxation in 1, axis malalignment in 2, and early arthrosis in 4.
- Successful outcomes support surgical intervention for delayed pediatric radial head luxation.
Conclusions:
- Surgical reconstruction is a viable and recommended treatment for delayed radial head luxation in children.
- The procedure, sometimes combined with osteotomy, yields favorable long-term results.
- This study advocates for operative management in contrast to other reported approaches.
Abstract:
Only some cases and no long term follow-ups are reported in literature concerning the problem of delayed luxations of the radial head in children. 21 cases (19 acquired and 2 inherited) were treated in our hospital by operative procedure 12.5 months after the accident on the average. Disregarding one early and one late resection of the radial head we reconstructed the joint reposition and annular ligament plasty and if necessary correction osteotomy of the ulnar or shortening of the radius. Follow-up examination took place between 2 and 16 years after the operation, 7.9 years on the average. A reluxation was observed in 2 cases, a subluxation in 1 case. 2 patients showed a wrong axis and 4 patients signs of a beginning radio-humeral arthrosis, but most results were good or satisfactory. Therefore a reconstruction of a luxation of the radial head in children is recommended in delayed cases (sometimes in combination with a correction osteotomy of the ulna or radius) in contrast to other authors.