Treatment of congenital radial head dislocation with a computer-assisted hexapod external fixator: A case report

Abstract

ÖZETKonjenital radius başı çıkığı (KRBÇ) dirsekte eklem sertliği, atlama, kilitlenme veya ağrıya neden olabilen doğumsal bir anomalidir. Bunun yanında tanı insidental olarak çekilen direkt grafilerle de konulabilmektedir. Tedavide amaç semptomları iyileştirmek ve hareket açıklığı tam olan bir dirsek eklemi elde etmektir. Literatürde çeşitli tedavi yöntemleri bildirilmektedir. Konvansiyonel veya bilgisayar destekli eksternal fiksatör sistemleri ekstremite deformiteleri, eklem kontraktürleri, akut kırıkların tespiti gibi klinik durumlarda kullanılmaktadır. Ancak bilgisayar destekli eksternal fiksatör ile tedavi edilmiş bir KRBÇ olgusuna rastlanmamaktadır. Bu yazımızda adelosan çağına kadar asemptomatik olan ve sonrasında dirsekte kilitlenme ve atlama şikayetleri ile kliniğimize başvuran ve proksimal ulna translasyon ve uzatma osteotomisi ve bilgisayar destekli eksternal fiksatör tatbiki ile başarılı bir şekilde tedavi ettiğimiz KRBÇ olgusunun fonksiyonel klinik ve radyolojik sonuçlarını sunuyoruz.Anahtar kelimeler: Radius başı, konjenital çıkık, hegzapod eksternal fiksatör ABSTRACT Congenital dislocation of the radial head (CDRH), a congenital anomaly of the elbow, can cause symptoms such as joint stiffness, snapping, locking, or pain, however the diagnosis is sometimes made incidentally from x-rays. The treatment goal is to ameliorate the symptoms and obtain a joint with a full range of motion. This paper presents a case of unilateral CDRH that was asymptomatic until adolescence, when locking and snapping developed. Several treatment options are described in the literature. Although the conventional and computer-assisted external fixator systems are used in several clinical pictures such as extremity deformities, joint contractures and fixation of acute fractures etc a computer-assisted external fixator system has not been used for CDRH. We successfully performed ulnar dorsal translation and a lengthening osteotomy with a computer-assisted external fixator to reduce the radial head indirectly and had satisfactory functional and clinical results. J Clin Exp Invest 2015; 6 (3): 301-305

Radial head excision in the treatment of congenital radial head dislocation: a case report

“…11 The goal is to ameliorate the symptoms and to recover the optimal ROM. 12 In this report, our patient presented with a restricted ROM in the right elbow. Hence, operative treatment was indicated.…”

“…When there is a significant symptom, such as elbow pain, or restricted ROM, operative treatment is indicated 11. The goal is to ameliorate the symptoms and to recover the optimal ROM 12. In this report, our patient presented with a restricted ROM in the right elbow.…”

Double ulnar osteomy for the treatment of congenital radial head dislocation

“…CRHD is an infrequent congenital disease characterized by asymmetry of bilateral elbow and sometimes restricted movement on elbow 15 . This disease is very likely neglected before adolescence in most of the patients with CRHD because of mild symptoms 16 .…”