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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 1, 88-94.
doi: 10.1302/0301-620X.87B1.14669  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Open reduction, ulnar osteotomy and external fixation for chronic anterior dislocation of the head of the radius

C. C. Hasler, MD, Consultant Orthopaedic Surgeon; L. Von Laer, MD, Professor; and A. K. Hell, MD, Consultant Orthopaedic Surgeon

Orthopaedic Department, University Children’s Hospital, P O Box, Römergasse 8, 4005 Basel, Switzerland.

Correspondence should be sent to Dr C. C. Hasler.

We reviewed 15 patients, nine girls and six boys, with chronic anterior dislocation of the radial head which was treated by ulnar osteotomy, external fixation and open reconstruction of the elbow joint but without repair of the annular ligament. Their mean age was 9.5 years (5 to 15) and the mean interval between the injury and reconstruction was 22 months (2 months to 7 years).

All radial heads remained reduced at a mean follow-up of 20 months (6 months to 5 years). Normal ranges of movement for flexion, extension, pronation and supination were unchanged in 96.1% (49/51) and worse in 3.9% (2/51). Limited ranges of movement were improved in 77.8% (7/9), unchanged in 11% (1/9) and further decreased in 11% (1/9).There were two superficial pin-track infections and two cases of delayed union but with no serious complications. Reconstruction of the radiocapitellar joint is easier using external fixation since accurate correction of the ulna can be determined empirically and active functional exercises started immediately. Only patients with a radial head of normal shape were selected for treatment by this method.




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T. S. Jepegnanam
Salvage of the radial head in chronic adult Monteggia fractures: REPORT OF FOUR CASES
J Bone Joint Surg Br, May 1, 2006; 88-B(5): 645 - 648.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General