Traumatic isolated anterior dislocation of the radial head in an adult: A case report

Watanabe, Kota; Iwabu, Shohei; Hosoya, Toshihiko

doi:10.1016/j.jse.2004.08.005

Cited by 21 publications

(30 citation statements)

References 7 publications

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“…The interposition of the annular ligament has also been described as the cause of the irreducible anterior dislocation of the radial head. The ligament suffers no injury and is interposed between the dislocated radial head and the capitellum [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Irreducible Anteromedial Dislocation of Radial Head with Biceps Tendon Interposition

Climent-Péris

Sirera-Vercher

Sanz-Amaro

2016

Case Reports in Orthopedics

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The case presents an isolated irreducible anteromedial dislocation of radial head due to biceps tendon interposition on a 14-year-old female patient. After an unsuccessful closed reduction, a lateral approach of the left elbow was carried out through Kocher's interval. Given that no pathology was found on the radiohumeral joint, the approach was extended distally. This revealed that the biceps tendon was displaced laterally around the radial neck, preventing the reduction. Once the tendon was taken back to its anatomical position, the radial head reduction was performed successfully. The patient achieved a complete functional recovery. Possible injury mechanisms are discussed, as well as the importance of identifying such a rare injury.

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Section: Discussionmentioning

confidence: 99%

Irreducible Anteromedial Dislocation of Radial Head with Biceps Tendon Interposition

Climent-Péris

Sirera-Vercher

Sanz-Amaro

2016

Case Reports in Orthopedics

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“…Various mechanisms of injury have been described for anterior dislocation of the radial head: forceful biceps contraction, hyper-pronation associated with slight elbow flexion and varus strain from a fall, direct blow to the posterior aspect of a semiflexed elbow, and hyperextension in supination [4-7,11]. In our case, the mechanism was entrapped forearm, which has never been described.…”

Section: Case Reportmentioning

confidence: 56%

“…Unsuccessful closed reduction of anterior dislocations is due to a torn and/or incarcerated annular ligament/LCL complex and these structures must first be released and repaired [11,12]. This was the case in our patient as two unsuccessful closed reduction attempts were performed.…”

Section: Case Reportmentioning

confidence: 97%

Upper extremity compartment syndrome after minor trauma: an imperative for increased vigilance for a rare, but limb-threatening complication

Seigerman¹,

Choi²,

Donegan³

et al. 2013

Patient Saf Surg

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BackgroundCompartment syndrome of any extremity is a limb-threatening emergency requiring an emergent surgical management. Thus, ruling out compartment syndrome is often high on the list of priorities when treating high-energy injuries and fractures. However, even in the most seemingly benign injuries, this dangerous diagnosis must always remain on the differential and suspicion must remain high.Case presentation23-year-old factory worker presents after a low energy entrapment injury to his left forearm. Initial work-up and evaluation noted an isolated radial head dislocation with a normal physical motor and sensory exam. However, maintaining high suspicion for compartment syndrome despite serial normal physical exams, led objective compartment pressure measurement leading to definitive diagnosis. Emergent surgical intervention via compartment fasciotomies was performed, along with closed reduction and ligament repair. At 1 year follow-up, the patient was well-healed, back to work with full range of motion and not activity limitations.ConclusionDespite a seemingly benign injury pattern, and a relatively low energy mechanism, vigilant concern for compartment syndrome following any kind of entrapment injury should initiate serial examinations and compartment pressure measurements especially in circumstances with continued swelling and inability to perform an accurate clinical assessment due to an obtunded or medicated patient.

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“…Traumatic radial head dislocation is usually associated with fractures of the forearm [6,7]. Isolated radial head dislocation in children is rare and most of this injury represent a monteggia-variant lesion, with plastic deformation of the ulna.…”

Section: Discussionmentioning

confidence: 99%

Isolate and irreducible radial head dislocation in children: a rare case of capsular interposition

Tarallo

Novi

Porcellini

et al. 2020

BMC Musculoskelet Disord

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Background Radial head dislocation with no associated lesions, is a relatively uncommon injury in children. In this case report, it is reported a case of anteromedial locked radial head dislocation in children, and we discuss its clinical presentation and pathogenetic mechanism of injury. Case presentation An 8-year-old girl fell off on her right forearm with her right elbow extended in hyperpronation. An isolated radio-capitellar dislocation was identified with no other fractures or neurovascular injuries associated. Elbow presented an extension-flexion arc limited (0°- 90°), and the prono-supination during general anesthesia shows “a sling effect” from maximal pronation (+ 55°) and supination (+ 90°) to neutral position of forearm. The radial head dislocation was impossible to reduce and an open reduction was performed using lateral Kocher approach. The radial head was found “button-holed” through the anterior capsule. The lateral soft tissues were severely disrupted and the annular ligament was not identifiable. Only by cutting the lateral bundle of the capsule was possible to reduce the joint. At 50 moths follow-up, patient presented a complete Range of motion (ROM), complete functionality and no discomfort or instability even during sport activities. Discussion and conclusion It is important to understand the pathogenic mechanisms of locked radial head dislocation in children. Some mechanism described are the distal biceps tendon or the brachialis tendon interposition. However even the anterior capsule can hinder reduction. A characteristic “sling-effect” of the forearm could be pathognomonic for capsular button-holing. Surgical release of the capsular bundle sometimes is the only way to reduce the dislocation and obtain a good outcome.

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Traumatic isolated anterior dislocation of the radial head in an adult: A case report

Cited by 21 publications

References 7 publications

Irreducible Anteromedial Dislocation of Radial Head with Biceps Tendon Interposition

Irreducible Anteromedial Dislocation of Radial Head with Biceps Tendon Interposition

Upper extremity compartment syndrome after minor trauma: an imperative for increased vigilance for a rare, but limb-threatening complication

Isolate and irreducible radial head dislocation in children: a rare case of capsular interposition

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