Chronic radial head dislocation in children, Part 1: pathologic changes preventing stable reduction and surgical correction.
The pathologic changes in 15 elbows of 14 children (2 bilateral congenital, 12 unilateral posttraumatic, mean age 9.5 years) with radial head dislocation unreduced for at least 3 months (range 3-180 months) and their open treatment were reviewed. Common dysplastic changes observed in both congenital and posttraumatic groups included large deformed radial heads, slender radial necks, and ulnar bowing. Changes were bilateral and symmetrical in the congenital group. In traumatic dislocations, patients with more severe deformities had longer delays from time of injury to time of reduction. Persistent pain, limitation of motion, and deformity were unacceptable symptoms to both patients and their parents, prompting surgical intervention. To produce a smooth rotational arc for the radius and maintain it in stable reduction, restoration of the congruency of the capitello-radioulnar joint and correction of the various dysplastic changes were mandatory during open reduction.
Pediatric Orthopaedic Unit, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan, Korea. kimht@hyowon.pusan.ac.kr
Hui Taek
HT
Kim
Jesse Noel V
JN
Conjares
Jeung Tak
JT
Suh
Chong Il
CI
Yoo
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003646:Debridement; D004551:Elbow Joint / Q000503:physiopathology; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008297:Male; D009011:Monteggia's Fracture / Q000473:pathology* / Q000601:surgery; D010027:Osteotomy; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D014457:Ulna / Q000601:surgery