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Pediatric Proximal Radioulnar Translocation: A Case Report, Literature Review, and Technique for Successful Closed
Alyssa Barré1, Joseph Hare1, Lindsay Hockensmith1
1Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky, United States.
Introduction:
While pediatric elbow dislocations are a common injury, rare variants of this injury exist including translation of the proximal radius and ulna. This injury is associated with high rates of neurovascular injury and delayed diagnosis. This report discusses a case of proximal radioulnar translocation, emphasizes the importance of early detection, and describes a closed reduction (CR) technique, which has not previously been described.
Case Report:
A 9-year-old presented to our hospital with a proximal radioulnar translocation with ulnar nerve paresthesias. CR was successful via the technique described in this article. Open ulnar nerve exploration was performed with only bruising to the nerve. The paresthesias resolved and she had full elbow functional range of motion and had returned to gymnastics at her two-year follow-up.
Conclusion:
Pediatric proximal radioulnar translocations are a rare injury with less than 30 documented in the literature. Although rare, they have high rates of complications including nerve injuries, and are often missed. Effective CR can lead to a favorable outcome without the need for open surgery. A CR technique is illustrated in this article.
