Congenital dislocation of the radial head: spectrum and natural history

A retrospective review of 24 patients with congenital radial head dislocation and three patients with congenital elbow dysplasias was performed. Eight patients had only congenital radial head dislocations and no other anomalies. In these eight patients, a noted limitation of elbow and forearm motion was greatest in those with anterior dislocations. Limitation of wrist motion also was noted in all affected extremities. Unilateral congenital radial head dislocation as well as progressive subluxation to dislocation were documented. There was no increased loss of motion as growth occurred. Significant pain was noted only in adults. Radial head excision after age 15 relieved pain and improved cosmesis but failed to significantly affect motion. Excision performed prior to this age showed regrowth of the proximal radius. A finding of increased ulnar length in relation to the radius in wrist roentgenograms of affected extremities was a significant diagnostic sign.