Chronic posttraumatic anterior dislocation of the radial head in children: thirteen cases treated by open reduction, ulnar osteotomy, and annular ligament reconstruction through a Boyd incision.
OBJECTIVE
To report the results of open reduction, ulnar osteotomy, and annular ligament reconstruction all through a Boyd incision for chronic radial head dislocations in children.


METHODS
Retrospective review.


METHODS
Tertiary pediatric orthopaedic care unit at a general hospital in Taichung, Taiwan.


METHODS
From 1986 to 2003, 13 children, aged 4 to 13 (mean, 8.3) years, who had a chronic traumatic anterior dislocation of the radial head were treated at our institute. These patients were seen at our hospital 2 to 36 (mean, 8.2) months after injury.


METHODS
Open reduction of the radial head, ulnar osteotomy, then rigid fixation with plate/screws, and annular ligament reconstruction with forearm fascia, all performed through a Boyd incision.


METHODS
Forearm radiographs for reduction and osteotomy site union, physical examinations for elbow mobility, and Kim's elbow performance scores for overall elbow function. Evaluations were done at a special follow-up clinic for this study by a pediatric orthopaedic surgeon who was not involved in the patients' previous care.


RESULTS
Patient follow-up averaged 7.8 (range, 1-16.9) years after surgery. Twelve of our cases had successful radial head reductions, satisfactory elbow mobility, and excellent functional outcome. One case had a redislocation, was retreated, and had a fair result. Other complications included 1 patient with transient posterior interosseous nerve palsy, and 1 delayed union of an ulnar osteotomy site, which healed without further intervention at 1 year with an excellent result.


CONCLUSIONS
This surgical procedure provides a high success rate with a low level of complications for chronic radial head dislocations in children.
Wang
Matthew N
MN
Department of Orthopaedic Surgery, Kuang-Tien General Hospital, Taichung, Taiwan. admin_tachia@ktgh.com.tw
Chang
Wei-Ning
WN
D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004551:Elbow Joint / Q000503:physiopathology; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D009011:Monteggia's Fracture / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D010027:Osteotomy; D011884:Radius / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D014457:Ulna / Q000601:surgery*; D000092464:Elbow Injuries