Case report: congenital dislocation of the radial head –a two-in-one approach

Background: Congenital dislocation of the radial head of the elbow is rare. It is genetically transmitted in some cases and is often associated with syndromes, such as Nail-Patella syndrome, antecubital pterygium and ulnar dysplasia. About two thirds are posterior, with the remainder being either an...

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Autores principales: Karuppal, Raju, Marthya, Anwar, Raman, Rajendran V, Somasundaran, Sandhya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: F1000Research 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857746/
https://www.ncbi.nlm.nih.gov/pubmed/27158442
http://dx.doi.org/10.12688/f1000research.3-22.v1
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author Karuppal, Raju
Marthya, Anwar
Raman, Rajendran V
Somasundaran, Sandhya
author_facet Karuppal, Raju
Marthya, Anwar
Raman, Rajendran V
Somasundaran, Sandhya
author_sort Karuppal, Raju
collection PubMed
description Background: Congenital dislocation of the radial head of the elbow is rare. It is genetically transmitted in some cases and is often associated with syndromes, such as Nail-Patella syndrome, antecubital pterygium and ulnar dysplasia. About two thirds are posterior, with the remainder being either anterior (15%) or lateral (15%). The natural history of the condition is that symptoms are relatively benign, with only some limitation of motion and deformity. Treatment either involves early attempts at reconstruction or delayed intervention at skeletal maturity with radial head excision. We evaluated the radiographic and functional results of a two-in-one procedure (radial shortening and open reduction) in the treatment of congenital dislocation of the radial head of an eight year old girl. Objective: To describe a technique for easy reduction and maintenance of normal radiocapitellar joint anatomy in cases of congenital dislocation of the radial head. Method: We have introduced one modification to the Sachar’s method of open reduction by adding radial shortening. This can be described as a ‘two incision approach’ with the first incision for the radial shortening and the second for the open reduction of the radiocapitellar joint. The radial shaft was osteotomised first before we performed the radial head relocation. Then the overlapping part of radial shaft was trimmed. It was stabilized with a transarticular K wire fixation. Results: At one year follow up, the elbow is stable with no valgus or fixed flexion deformity. Supination has increased to 40 degrees from zero degrees. An X-ray showed reformation of the radial head with good congruity of the radiocapitellar joint and correction of the radial bow. Conclusion: As far as the authors are aware, this is the first report of congenital dislocation of the radial head being treated by radial shortening and open reduction of radiocapitellar joint through a two incision approach (two-in-one approach). This paper describes this new technique, which we implemented for easy reduction maintenance of normal radiocapitellar joint anatomy.
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spelling pubmed-48577462016-05-06 Case report: congenital dislocation of the radial head –a two-in-one approach Karuppal, Raju Marthya, Anwar Raman, Rajendran V Somasundaran, Sandhya F1000Res Case Report Background: Congenital dislocation of the radial head of the elbow is rare. It is genetically transmitted in some cases and is often associated with syndromes, such as Nail-Patella syndrome, antecubital pterygium and ulnar dysplasia. About two thirds are posterior, with the remainder being either anterior (15%) or lateral (15%). The natural history of the condition is that symptoms are relatively benign, with only some limitation of motion and deformity. Treatment either involves early attempts at reconstruction or delayed intervention at skeletal maturity with radial head excision. We evaluated the radiographic and functional results of a two-in-one procedure (radial shortening and open reduction) in the treatment of congenital dislocation of the radial head of an eight year old girl. Objective: To describe a technique for easy reduction and maintenance of normal radiocapitellar joint anatomy in cases of congenital dislocation of the radial head. Method: We have introduced one modification to the Sachar’s method of open reduction by adding radial shortening. This can be described as a ‘two incision approach’ with the first incision for the radial shortening and the second for the open reduction of the radiocapitellar joint. The radial shaft was osteotomised first before we performed the radial head relocation. Then the overlapping part of radial shaft was trimmed. It was stabilized with a transarticular K wire fixation. Results: At one year follow up, the elbow is stable with no valgus or fixed flexion deformity. Supination has increased to 40 degrees from zero degrees. An X-ray showed reformation of the radial head with good congruity of the radiocapitellar joint and correction of the radial bow. Conclusion: As far as the authors are aware, this is the first report of congenital dislocation of the radial head being treated by radial shortening and open reduction of radiocapitellar joint through a two incision approach (two-in-one approach). This paper describes this new technique, which we implemented for easy reduction maintenance of normal radiocapitellar joint anatomy. F1000Research 2014-01-22 /pmc/articles/PMC4857746/ /pubmed/27158442 http://dx.doi.org/10.12688/f1000research.3-22.v1 Text en Copyright: © 2014 Karuppal R et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Karuppal, Raju
Marthya, Anwar
Raman, Rajendran V
Somasundaran, Sandhya
Case report: congenital dislocation of the radial head –a two-in-one approach
title Case report: congenital dislocation of the radial head –a two-in-one approach
title_full Case report: congenital dislocation of the radial head –a two-in-one approach
title_fullStr Case report: congenital dislocation of the radial head –a two-in-one approach
title_full_unstemmed Case report: congenital dislocation of the radial head –a two-in-one approach
title_short Case report: congenital dislocation of the radial head –a two-in-one approach
title_sort case report: congenital dislocation of the radial head –a two-in-one approach
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857746/
https://www.ncbi.nlm.nih.gov/pubmed/27158442
http://dx.doi.org/10.12688/f1000research.3-22.v1
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