Ulnar Rotation Osteotomy for Congenital Radial Head Dislocation

Liu, Ruiyu; Miao, Wei; Mu, Mingchao; Wu, Ge; Qu, Jining; Wu, Yongtao

doi:10.1016/j.jhsa.2015.06.005

Cited by 5 publications

(7 citation statements)

References 15 publications

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“…The skin incision began with the 2.5 cm of proximal elbow, laterally came to the triceps tendon and distally over the lateral side of the tip of the olecranon, along the subcutaneous border of the ulna. Subsequently, the RH was exposed using Boyd approach, which was useful to reach the radius and ulna in their proximal position 9 . We found that the RH was the anterior dislocation, and after exposure of the RH, there was normal synovial fluid in the intact articular cavity of elbow joint and without scar tissue (Fig.…”

Section: Methodsmentioning

confidence: 94%

“…Therefore, we projected an ulnar rotation osteotomy to adjust the radial notch of ulna and resolve the dislocation of RH. Although this rotation method could improve the ROM of the elbow flexion and extension, the elbow function of pronation or supination was limited in some patients at follow-up 9 . For this reason, a new method named as double osteotomy was used to resolve this deficiency.…”

Section: Discussionmentioning

confidence: 99%

“…and functional loss 5 . More recently, our teams establish an effective operative treatment (ulnar rotation osteotomy) for children in CRHD to enhance the motion of elbows 9 . The distal cut surface is rotated in the posterolateral side to make humeroradial joint recovered during the ulnar rotation osteotomy.…”

Section: Introductionmentioning

confidence: 99%

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Double ulnar osteomy for the treatment of congenital radial head dislocation

Jie¹,

Liang²,

Wang³

et al. 2019

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveThe aim of this study was to retrospectively evaluate the effects of our double osteotomy technique in the treatment of congenital radial head dislocation (CRHD).MethodsA total 14 children (14 elbows; 71.42% male; mean age: 9.31 ± 3.06 years) with CRHD who underwent double osteotomy of the proximal ulna between April 2010 and June 2015 were included in the study. The patients with CRHD were identified according to medical history, plain radiographs or magnetic resonance imagings. The outcomes were evaluated through comparison of the preoperative and postoperative motion range of elbow and Mayo Elbow Performance Score (MEPS).ResultsAfter a follow-up of 13–35 months (22.29 ± 5.80), compared with pre-operation, the flexion (132.14 ± 3.23° vs 123.21 ± 7.75°, P = 0.003), extension (8.21 ± 4.21° vs 1.07 ± 3.50°, P = 0.003), and pronation of elbow (83.21 ± 4.21° vs 80.36 ± 4.14°, P = 0.011) improved significantly in all patients. Furthermore, the carrying angle was recovered to the normal level (5–15°) in all of these patients (18.57 ± 5.69° vs 8.21 ± 2.49°, P = 0.001). MEPS score was significantly increased postoperatively (96.79 ± 2.49 vs. 90.71 ± 1.82, P = 0.000), with the good outcome in CRHD patients.ConclusionThe results of our study suggested that this double osteotomy on the proximal ulna might be an effective method for the treatment of CRHD.Level of EvidenceLevel IV, Therapeutic Study.

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Section: Methodsmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Double ulnar osteomy for the treatment of congenital radial head dislocation

Jie¹,

Liang²,

Wang³

et al. 2019

Acta Orthopaedica et Traumatologica Turcica

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“…It can further increase the strength of the pronator teres and pronator quadratus muscles. According to the literature, ulna osteotomy can also be applied in pediatric ulna deformity cases with favorable outcomes ( 5 , 29 ), but it should be weighing against the potential risks of progressive cubitus valgus, supination weakness, and limitation in functional improvement in adult cases ( 11 , 18 , 24 ).…”

Section: Discussionmentioning

confidence: 99%

Bilateral anterior congenital radial head dislocation in adults: a case report and literature review

Gao

Tang

et al. 2023

Front. Surg.

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ObjectiveCongenital dislocation of the radial head (CRHD) is a rare condition, with bilateral anterior cases being even less common worldwide. Only a few cases had residual pain after adulthood, even when left untreated. Herein, we describe an adult case of bilateral anterior CRHD with significant pain and snapping during motion. The aim of this study was to report the physical and radiological findings, treatment methods, and short-term outcomes of our case and to review adult CRHD cases in the literature.PatientA 21-year-old male patient presented to our hospital with chief complaints of snapping and exacerbated pain during motion in his left elbow.Diagnoses and interventionsDetailed medical history and physical examination results were recorded. Radiographic examinations were performed on the bilateral elbow, and the diagnosis of bilateral anterior congenital radial head dislocation was confirmed. To relieve the pain and snapping in the left elbow, we performed open reduction and fixation of the radial head with annular ligament reconstruction and ulnar osteotomy. Postoperatively, the elbow rested at 90° flexion with a cast for 16 weeks, and the K-wire was removed on the 10th week; afterward, active functional exercises were performed.OutcomesThe patient was followed-up for 1 year. The pain in his left elbow was relieved with a reduction in the visual analog scale score from 7 to 3. The range of motion of the left elbow was changed from 0° to 135° (preoperative) to −5° to 120° (postoperative) (extension–flexion) without any snapping. However, restrictions in external rotation have not yet been fully resolved. Further physical rehabilitation is required.ConclusionWhen managing patients with congenital radial head dislocation, the contralateral elbow should be evaluated to identify potential bilateral cases. Surgical options should be discussed with adult patients only for the strong need for functional improvement, although the outcomes may not be fully satisfactory.

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“…The PUB, a measure of proximal ulnar kyphosis deformity, tended to be large in cases of radial head dislocation. Osteoarthritis of the elbow develops in adults due to a history of these alignment abnormalities and dislocations [ 21 ]. In this study, elbow OA occurred in four out of six patients aged 20 to 50 years (66.7%), which is an extremely high incidence rate even when considering the 25% prevalence of elbow OA in the general population aged from 50 to 90 years [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Presentation and Characteristics of the Upper Extremity in Patients with Musculocontractural Ehlers–Danlos Syndrome

Isobe

Hayashi

Kobayashi

et al. 2022

Genes

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Musculocontractural Ehlers–Danlos syndrome (mcEDS) is a subtype of EDS caused by defective dermatan sulfate biosynthesis, characterized by multiple malformations (craniofacial features, ocular and visceral malformations) and progressive cutaneous, skeletal, vascular, and visceral fragility-related manifestations. Repeated dislocations and deformities of the joints due to joint relaxation are observed, causing serious damage to the musculoskeletal system of the whole body; however, the motor function of the upper limbs and the morphology of the bone joints have not been systematically investigated. In this study, we present a detailed and comprehensive report on upper limb lesions of 13 patients with a mean age at the first visit of 21 years. Twelve patients (92.3%) had a history of dislocation. Eleven patients (84.6%) had shoulder dislocations, and two patients (15.4%) had elbow dislocations. Four patients (30.8%) had elbow osteoarthritis, and three patients (23.1%) had distal radioulnar joint (DRUJ) osteoarthritis. The phalanges and metacarpals are thin, and the ratio of medullary cavity of the metacarpal bone decreases with age. As bone and joint deformity progresses, patients with mcEDS should be recommended to receive regular follow-up, including radiology. The present findings suggest an important role for dermatan sulfate in the maintenance of the skeletal system.

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Ulnar Rotation Osteotomy for Congenital Radial Head Dislocation

Cited by 5 publications

References 15 publications

Double ulnar osteomy for the treatment of congenital radial head dislocation

Double ulnar osteomy for the treatment of congenital radial head dislocation

Bilateral anterior congenital radial head dislocation in adults: a case report and literature review

Clinical Presentation and Characteristics of the Upper Extremity in Patients with Musculocontractural Ehlers–Danlos Syndrome

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