Annular ligament reconstruction by suture anchor for treatment of radial head dislocation in children

Abstract

BackgroundWe investigated the efficacy of annular ligament reconstruction by suture anchor in the treatment of radial head dislocation (RHD) in children.MethodA total of 20 RHD children nderwent annular ligament reconstruction surgery using suture anchor. Preoperative and postoperative elbow functions were evaluated according to Broberg and Morrey 100-point scale. Recovery of radial nerve function was assessed using the Chinese Medical Association of Hand Surgery Branch of Upper Limb Functional Assessment Standard. All statistical analyses were performed using SPSS version 17.0 software.ResultsAll 20 RHD children who underwent the procedure were followed up for a median duration of 24 months. At the last follow-up, the average Broberg-Morrey score was 94.3, with 12 children (60.0 %) showing excellent outcomes (score range, 95 to 100), 7 children (35.0 %) showing good outcomes (score range, 80 to 94), 1 child (5.0 %) displayed a fair outcome (score range, 60 to 79), and 0 (0 %) poor outcome. A significant difference in the excellent-good rate was observed when the elbow function before surgery was compared to after surgery (χ2 = 5.559, P = 0.018). The radial nerve function of the 13 RHD children with radial nerve injury also recovered to normal. Among these 13 RHD children, nine exhibited excellent outcomes, 3 showed good outcomes, 1 displayed a fair outcome, and no patient showed a poor outcome. A significant difference in the excellent-good rate of radial nerve function was also observed when before surgery was compared to after surgery in these RHD children (χ2 = 4.887, P = 0.027).ConclusionOur results strongly indicated that suture anchor is highly effective for reconstruction of the annular ligament and to promote full functional recovery in RHD children, demonstrating that the procedure is an excellent treatment choice in RHD children.

Corrective osteotomy for a malunited proximal radius fracture causing radio-capitellar dislocation in a paediatric patient: A case report

“…[9][10][11] For traumatic radial head dislocations, annular ligament reconstruction has also been shown to be efficacious. [11][12][13] However, these cases are related to Monteggia-type injuries and when such a clinical malalignment is faced with, a pure soft tissue procedure would not be appropriate. Hazel and Bindra 14 discussed revising a radial osteotomy intraoperatively owing to radial head subluxation being present after an opening wedge osteotomy was performed; however, this case differs from ours in several ways.…”

Outcomes of Paediatric Elbow Dislocations

“…The occurrence of this complication is due to the failure of the capsule and ligamentous structures to be reattached after traumatic dislocation 5 , 18 , 19 . The rate of recurrence increases when treatment was delayed or incomplete 20 . Recurrence of dislocation was not seen in our series.…”

A novel technique of annular ligament reconstruction using extensor carpi radialis longus tendon fascia: a report of 3 cases

“…procedure have been described. [8][9][10] Using each of these tissues is associated with its own complications. In our technique we have used the fascia of the extensor carpi radialis longus tendon for repair of the annular ligament in 3 cases of chronic Monteggia fracture-dislocation.…”