Radial neck osteolysis after annular ligament reconstruction. A case report

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Reconstructive surgery

Background:

• Late Monteggia lesions, characterized by radial head dislocation, present complex treatment challenges.
• Annular ligament reconstruction using a triceps tendon strip is a frequent surgical approach for these injuries.
• While generally successful, the comprehensive complication rate of this reconstructive technique is not well-established.

Observation:

• This report details a case involving a 9-year-old male patient.
• The patient underwent annular ligament reconstruction for a previously undetected radial head dislocation.
• The reconstruction utilized a sling fashioned from the triceps tendon.

Findings:

• The patient experienced avascular necrosis of the radial neck.
• Significant bone resorption of the radial neck was also observed post-operatively.
• These complications arose following the reconstructive surgery for the late Monteggia lesion.

Implications:

• This case highlights a potential severe complication associated with annular ligament reconstruction in pediatric patients with late Monteggia lesions.
• It underscores the need for careful patient selection and monitoring after such procedures.
• Further research into the long-term outcomes and complication rates of this surgical technique is warranted to inform clinical practice.