Related Experiment Video
Updated: Feb 5, 2026
A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
Irreducible Dislocation of the Radial Head Associated With Pediatric Monteggia Lesions
Muneaki Abe1, Hozumi Kumano1, Akihiko Kinoshita1
1Department of Orthopedic Surgery, Shiroyama Hospital, Habikino, Japan (Dr. Abe, Dr. Kumano, and Dr. Kinoshita), and the Department of Orthopedic Surgery, Osaka Medical College, Takatsuki, Japan (Dr. Hirofuji).
Background:
In pediatric patients with Monteggia lesions, the radial head can be reduced manually when displacement of the fractured ulna is corrected. Occasionally, however, a dislocated radial head could not be reduced manually even when the length and/or angulation of the fractured ulna had been corrected. We can find such cases in the literature, but those are single case reports. We encountered 17 cases of irreducible dislocation of the radial head in pediatric Monteggia lesions during the past 43 years. The purposes of this study were to identify the characteristics of our cases and to discuss the factors that inhibited reduction of the radial head.
Methods:
Of 109 children treated for Monteggia lesions between 1972 and 2015, we encountered 17 cases of irreducible dislocation of the radial head. The patients' ages averaged 7.1 years, ranging from 2.6 to 12.1 years. Directions of the radial head dislocation were anterior in five cases, anteromedial in four, lateral in one, and anterolateral in seven. Most of the patients were referred to us from local orthopaedic clinics because of irreducibility of the radial head. We reduced the radial head surgically and confirmed the causes of irreducibility.
Results:
In 10 of the 17 cases, the problem was identified as pseudoreduction. In those cases, the radial head was reduced in a supination position but redisplaced in a pronation position. Causes of irreducibility were traced to the annular ligament in 15 cases, biceps tendon in 1, and posterior interosseous nerve in 1.
Conclusions:
In cases of pediatric Monteggia lesions, we should pay attention to patients in whom the dislocated radial head is not reduced after closed reduction. The most frequent cause of hindered reduction was interposition of the annular ligament in the radiocapitellar joint. Here, the radial head seems to be reduced in the supination position but becomes redisplaced in the pronation position. After closed reduction, it is important to confirm whether the radial head is stable in both pronation and supination positions.
Level Of Evidence:
Diagnostic level IV.
More Related Videos
05:04Application of Passive Head Motion to Generate Defined Accelerations at the Heads of Rodents
Published on: July 21, 2022
06:57Theoretical Calculation and Experimental Verification for Dislocation Reduction in Germanium Epitaxial Layers with Semicylindrical Voids on Silicon
Published on: July 17, 2020
Related Concept Videos
01:23Radial System Protection
In a radial system with a fault downstream of the third breaker, ideally, only the third breaker will open, isolating the fault and interrupting the load connected beyond it. The second breaker has a longer delay setting,...
01:11Assessment of radial pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
01:19Muscles that Move the Head
The bilateral sternocleidomastoid, or SCM, and the suprahyoid and infrahyoid muscles are significant head flexors. The SCM muscles originate at the sternum and clavicle and attach to the mastoid process of the temporal bone. The SCM contracts bilaterally to bend the head forward, whereas...
01:25Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:26Arteries of the Head and Neck
The internal carotid arteries supply blood to the anterior portion of the cerebrum. They enter the...