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Radial Head Dislocation

Dislocation of the Radial Head


Presentation

  • We report a late presentation of a Type II Monteggia equivalent injury with a fracture of the radial head and neck and plastic deformation of the ulna in an 11-year-old boy.[ncbi.nlm.nih.gov]
  • We present an alternative hypothesis of dislocation after fracture healing and report the longest known period of delay between fracture and dislocation.[ncbi.nlm.nih.gov]
  • We present an unusual case of an isolated interosseous membrane disruption of the forearm without any fracture pattern. Dislocation of both radial head and distal radio-ulnar joint was presented.[ncbi.nlm.nih.gov]
  • We present a case of medial radial head dislocation without a concomitant ulna fracture in a 14-year-old girl and the long-term sequelae of the injury.[ncbi.nlm.nih.gov]
  • A review of the biomechanical studies of the elbow ligaments enables us to propose a pathophysiological model of this injury, and a case report and review of the literature are presented.[ncbi.nlm.nih.gov]
Asymptomatic
  • After a follow-up of 18 months, the child remained asymptomatic and regained a full range of motion. Radiographic study revealed satisfactory reduction of the radial head with no recurrence of the osteochondroma.[ncbi.nlm.nih.gov]
  • Congenital Radial Head Dislocation Follow-up Care Asymptomatic patients can be as active in sports as their function allows. May consider limiting contact sports.[eorif.com]
  • Although it can initially be asymptomatic, pain, restriction of movement and secondary arthritic changes may develop as the child grows [ 1, 2, 3, 4 ]. The treatment of chronic radial head dislocation remains controversial.[em-consulte.com]
Prolonged Immobilization
  • The pediatric elbow is more forgiving than the adult’s with respect to regaining full ROM after prolonged immobilization. Medication First Line Symptomatic treatment for pain is suggested.[orthopaedicclinic.com.sg]
Nail Deformity
  • Nail Patella Syndrome Essential Information: This uncommon syndrome has manifestations of nail deformity along with skeletal anomalies commonly involving the knees, elbows and pelvis.[posna.org]
Neglect
  • The recommended treatment has been controversial, ranging from benign neglect to surgical reconstruction.[ncbi.nlm.nih.gov]
  • If neglected, these can cause restriction of forearm supination and pronation, secondary degenerative arthritis of the elbow and distal radio-ulnar joints later on.[jocr.co.in]
  • Read More Posterior interosseous nerve palsy associated with neglected pediatric Monteggia fracture-dislocation: A case report. Int J Surg Case Rep 2016 26;27:102-106. Epub 2016 Aug 26.[pubfacts.com]
Excitement
  • Dear Reader, We are very excited about New Features in JOCR. Please do let us know what you think by Clicking on the Sliding “Feedback Form” button on the[jocr.co.in]

Treatment

  • All patients underwent surgical treatment and evaluation of radial head reduction and range of motion pre- and postoperatively.[ncbi.nlm.nih.gov]
  • The recommended treatment has been controversial, ranging from benign neglect to surgical reconstruction.[ncbi.nlm.nih.gov]
  • Awareness of this type of radial head dislocation is important to avoid delays in diagnosis and treatment.[ncbi.nlm.nih.gov]
  • There is very often a delay in diagnosis and treatment. Lincoln and Mubarak described the 'ulnar bow sign' in 1994. They accurately described the plastic deformity of the ulna and explained how to make a correct diagnosis from the radiographs.[ncbi.nlm.nih.gov]
  • BACKGROUND: Little 3-dimensional biomechanical investigation of plastic bowing deformity of the ulna has been reported, and the purpose of this study was to conduct such an investigation to elucidate mechanisms of injury and appropriate treatments.[ncbi.nlm.nih.gov]

Prognosis

  • Conservative observation Surgical early presentation (infancy) radial head reduction must have only mild deformity of radial head and capitellum technique: osteotomy of radius annular ligament reconstruction late presentation radial head excision Outcomes: Prognosis[posna.org]
  • Treatment and prognosis The dislocation needs to be reduced, and sometimes closed reduction is possible. Failing this open reduction will be necessary 1 .[radiopaedia.org]
  • Follow-up Prognosis The prognosis is excellent for a functional ROM of the elbow, forearm, and wrist, particularly in patients Mild ROM restrictions may be present compared with the contralateral side but usually none that would be noted by the patient[orthopaedicclinic.com.sg]
  • What Is the Prognosis for a Dislocated Elbow? Generally, this injury heals well and has a good prognosis.[emedicinehealth.com]

Etiology

  • On the basis of the previously published data of 14 cases and our data, we have summarized the etiology, clinical features, natural history, and treatment of FFCD in the ulna.[ncbi.nlm.nih.gov]
  • […] synonyms: Congenital Radial Head Dislocation ICD-10 Q68.8 Other specified congenital musculoskeletal deformities Congenital Radial Head Dislocation Etiology / Epidemiology / Natural History most common congenital anomaly of the elbow etiology unknown[eorif.com]
  • Etiology unknown Genetics not specified 1/3 associated with other skeletal dysplasias Incidence unknown Associated Conditions radioulnar synostosis, ulnar dysplasia, nail-patella syndrome Clinical Evaluation: History / Exam Findings child is usually presents[posna.org]
  • It has been written that a unilateral dislocation indicates traumatic etiology. 1 That is not true, though bilateral dislocations are clearly more commonly congenital. 2, 3 It has been stated that direction of displacement distinguished congenital from[musculoskeletalkey.com]
  • Etiology The mechanism of injury is believed to be a fall onto the outstretched hand with the elbow extended and the forearm pronated, resulting in a varus stress on the elbow.[orthopaedicclinic.com.sg]

Epidemiology

  • […] synonyms: Congenital Radial Head Dislocation ICD-10 Q68.8 Other specified congenital musculoskeletal deformities Congenital Radial Head Dislocation Etiology / Epidemiology / Natural History most common congenital anomaly of the elbow etiology unknown[eorif.com]
  • Late reconstruction of a congenital dislocation will be fraught with failure except in very unusual circumstances. 7, 8 Etiology and Epidemiology Congenital dislocation of the radial head can be seen in isolation, in conjunction with other congenital[musculoskeletalkey.com]
  • Classification: Direction of radial head displacement: Anterior, posterior, or lateral Pathogenesis: Traumatic, congenital, or pathologic Epidemiology Radial head dislocations are uncommon injuries, usually occurring with an associated ulna fracture.[orthopaedicclinic.com.sg]
  • Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • Introduction Clinical definition subluxation (partial dislocation) of the radial head relative to the radiocapitellar joint also known as Nursemaid elbow Epidemiology incidence second most common serious elbow injury in children after supracondylar fractures[medbullets.com]
Sex distribution
Age distribution

Pathophysiology

  • A review of the biomechanical studies of the elbow ligaments enables us to propose a pathophysiological model of this injury, and a case report and review of the literature are presented.[ncbi.nlm.nih.gov]
  • Pathophysiology In the normal elbow, the critical restraint to radial head dislocation is the annular ligament. This ligament usually is torn or severely stretched in the case of a dislocation.[orthopaedicclinic.com.sg]
  • There is no support for the common assumption that a relatively small head of the radius as compared to the neck of the radius predisposes the young to this injury. [ citation needed ] Pathophysiology [ edit ] The distal attachment of the annular ligament[en.wikipedia.org]

Prevention

  • Closed reduction was not stable, and open reduction revealed the biceps tendon displaced posteriorly and laterally from the radial tubercle around the radial neck, which prevented stable reduction of the anteromedial dislocation of the radial head.[ncbi.nlm.nih.gov]
  • In individuals with pronator teres contractures, prophylactic surgical release can be performed to prevent dislocation 1 .[radiopaedia.org]
  • Additionally, the sutures cannot prevent the growth of radial head since they are absorbable [ 25 ].[bmcmusculoskeletdisord.biomedcentral.com]
  • The child’s compensatory shoulder and wrist motion usually prevents functional limitations and parental awareness until direct observation and inspection occurs. This is similar to the presentation of radioulnar synostosis (see Chapter 17 ).[musculoskeletalkey.com]
  • Long standing dislocations may prevent good results due to dysplastic changes of both the radial head and the capitellum [ 4, 8 ].[em-consulte.com]

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