Surgical Treatment for Chronic Radial Head Dislocation

Horii, Emiko; Nakamura, R.; S, Koh; Inagaki, Hisao; Yajima, Hiroki; Nakao, Etsuhiro

doi:10.2106/00004623-200207000-00014

Cited by 105 publications

(140 citation statements)

References 23 publications

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“…The mean arc of forearm rotation was also higher in the group treated with overcorrection osteotomy. Overcorrection of ulnar osteotomy has also been recommended by other authors [22,32,33,34] and may also help by eliminating the mechanical block to radial rotation from callus or fibrous tissue.…”

Section: Ulnar Osteotomymentioning

confidence: 99%

Corrective Ulnar Osteotomy and Annular Ligament Reconstruction by Fascia Lata in Neglected Monteggia Fracture Dislocation in Children.

Hưng

Sang²,

Nam³

2017

International Journal of Orthopaedics

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a prospective study 13 patients with mean age of 7 years and 7 months, who presented with neglected Monteggia fracture dislocation, were studied. The time interval between injury and presentation mean 7.2 months and ranged from 2 months to 25 months. The patients were classified according to Bado. All children underwent open reduction of the radiocapitellar joint, Ulnar osteotomy with angulation distraction and annular ligament reconstruction by fascia lata. We used Kim's score the for evaluation of our results. RESULTS:The mean follow-up period was 40.8 months. One of them without ulnar osteotomies healed uneventfully. Ulnar angulation at osteotomy site (°) mean 21.3° (16-25°); Ulnar lengthening at osteotomy site (cm) mean 0.85 cm (0.5-1.8 cm); Improvement PrePotoperation: Flexion-Extention 20.3%; Pronation 5,1%; Supination 13.7%; Total 13.7%. Surgical results: Excellent in 9; Good in 3; Fair in 1. Complication with nounion in 1 case, Cubitus valgus in 2 cases; Subluxation in 1 case. CONCLUSION:Late open reduction for chronically dislocated radial heads in children produces good to excellent results. Surgery for reduction should be attempted unless dysmorphism of the radial head restricts it. Open reduction with ulnar osteotomy with annular ligament reduction is the most commonly performed procedure and is expected to result in reduced pain and elbow deformity.statistically. ABSTRACT BACKGROUND: Neglected Monteggia fracture dislocation in children constitutes significant disability in respect to pain, stiffness, deformity, neurological compromise and restriction of activities of daily living. Many surgical technique have been described to manage neglected Monteggia fracture dislocation and common technique is the ulnar osteotomy for restoration of the ulnar length and reduction of the radial head with annular ligament reconstruction for restoration of the elbow biomechanics for this difficult problem.

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Section: Ulnar Osteotomymentioning

confidence: 99%

Corrective Ulnar Osteotomy and Annular Ligament Reconstruction by Fascia Lata in Neglected Monteggia Fracture Dislocation in Children.

Hưng

Sang²,

Nam³

2017

International Journal of Orthopaedics

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“…Radial head dislocation in children may cause osteoarthritis, posterior interosseous nerve palsy, and cubitus valgus deformities in the long term [4,7,9,17,18]. However, treatment for chronic radial head dislocation is still controversial.…”

Section: Introductionmentioning

confidence: 99%

“…However, treatment for chronic radial head dislocation is still controversial. To achieve open reduction of the radial head, ligament reconstruction [9,18,29,32], ulnar osteotomy [6,10], and a combination of both techniques [4,5,7,24,31,34,37] have been proposed. However, the radial Each author certifies that he or she, or a member of his or her immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.…”

Section: Introductionmentioning

confidence: 99%

“…head sometimes remains subluxated or redislocated, even after these procedures [4,6,7,18,24,29,31,37]. Nonsurgical treatment leaving the radial head dislocated also has been advocated [11,12].…”

Section: Introductionmentioning

confidence: 99%

“…However, in chronic radial head dislocations, the function of the interosseous membrane during forearm rotation in vivo is still unknown. In addition, ulnar osteotomy has been performed on the basis of the distal ulna and radius moving together through the interosseous membrane [6,7,24,34].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

In Vivo Three-dimensional Motion Analysis of Chronic Radial Head Dislocations

Miyake

Moritomo

Kataoka

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Forearm kinematics and interosseous membrane function in chronic radial head dislocations sustained in childhood are unknown. Several procedures have been performed to reduce the radial head on the basis of static preoperative assessment in only one forearm position, but clinical results are not always favorable. Questions/purposes We investigated the in vivo threedimensional (3D) kinematics and length changes of interosseous membrane ligaments during forearm rotation in chronic radial head dislocations using 3D CT registration techniques. Methods We examined 10 patients with chronic radial head dislocations (seven Type 1 and three Type 4 Monteggia lesions). To quantify kinematics, the axis of rotation (AOR) and radial head motion were investigated using computer bone models constructed from CT data placing the forearm in three positions. We also created six interosseous membrane ligaments and calculated their 3D lengths during forearm rotation.

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Monteggia Fracture Dislocations

Little

Draeger

2015

The Pediatric Upper Extremity

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Surgical Treatment for Chronic Radial Head Dislocation

Cited by 105 publications

References 23 publications

Corrective Ulnar Osteotomy and Annular Ligament Reconstruction by Fascia Lata in Neglected Monteggia Fracture Dislocation in Children.

Corrective Ulnar Osteotomy and Annular Ligament Reconstruction by Fascia Lata in Neglected Monteggia Fracture Dislocation in Children.

In Vivo Three-dimensional Motion Analysis of Chronic Radial Head Dislocations

Monteggia Fracture Dislocations

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