Elbow dislocation chronic children

OBJECTIVE: An abnormal radiocapitellar articulation may play a role in the development of capitellar osteochondritis dissecans (OCD). The objective of this study is to determine the prevalence of capitellar OCD in pediatric patients with chronic radial head subluxation (RHS) or radial head dislocation (RHD). MATERIALS AND METHODS: We searched the radiology reports generated at a large pediatric hospital between 2004 and 2012, to identify patients 8-18 years old with chronic RHS or RHD...

This retrospective study was designed to evaluate the outcomes of re-dislocation of the radial head after corrective osteotomy for chronic dislocation. A total of 12 children with a mean age of 11 years (5 to 16), with further dislocation of the radial head after corrective osteotomy of the forearm, were followed for a mean of five years (2 to 10). Re-operations were performed for radial head re-dislocation in six children, while the other six did not undergo re-operation ('non-re-operation group'). The active range of movement (ROM) of their elbows was evaluated before and after the first operation, and at the most recent follow-up...

BACKGROUND: Chronic dislocation of the radial head treatment in Monteggia fracture dislocation is still controversial. We present a large series of patients treated in our Institution. MATERIALS AND METHODS: The outcome of 22 children treated surgically between 1988 and 2011 for post-traumatic chronic radial head dislocation is reported. There were 12 girls and 10 boys with a mean age at surgery of 7.2 years (4.1-13.6). The mean interval between injury and treatment was 15...

BACKGROUND: Osteochondroma is the most common benign bone tumor of the upper limbs that occurs during the developmental phase of children. Solitary epiphyseal enchondromas can be usually found in the humeral capitellum, and the proximal ulna of the elbow. CASE PRESENTATION: Herein, we report the case of a 12-year-old boy of Han ethnicity with a developmental radial head dislocation with a progressive radius deformities, caused by a solitary osteochondroma which originated from the proximal metaphysis of the radius...

Monteggia fractures are uncommon and frequently missed injuries in children. This article aims to study, in a systematic manner, the surgical management and complications of treatment of chronic radial head dislocations. After screening of relevant abstracts, a total of 28 studies were included in the systematic review. A narrative synthesis of various treatment modalities has been discussed. This article concludes that open reduction should be attempted unless dysmorphism of the radial head restricts it. Open reduction with ulnar osteotomy with or without annular ligament reconstruction is the most commonly performed procedure and is expected to result in reduced pain and elbow deformity...

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In children, fracture-separation of the epiphyseal plate near the elbow joint is a common occurrence. However, separation of the distal humeral epiphysis is very rare, and in most cases, it is caused by high-impact trauma. In all reported cases, there has been a clear mechanism of injury. We report a case of an 11-year-old male patient who sustained separation of the distal humeral epiphyses bilaterally after 2 years of gymnastics, without a clear mechanism of injury. This patient had been using the vault since he was 9 years old, although children of that age do not normally perform on the vault...

BACKGROUND: Fractures of the proximal third of the ulna and radius with associated anterior radial head dislocation are uncommon in children. Early recognition and appropriate management are essential to prevent long-term consequences of loss of forearm rotation, cubitus valgus, elbow instability and chronic pain. CASE PRESENTATION: We present the case of a 3-year-old Caucasian boy who attended the emergency department following an un-witnessed fall, resulting in right elbow and forearm pain, swelling and deformity...

BACKGROUND: Chronic, subacute, and chronic Monteggia fracture dislocations of the elbow are challenging problems. The literature generally recommends complex open reconstructive procedures. We present an alternative, minimally invasive, percutaneous method with external fixation. METHODS: This was a retrospective review of 4 cases presenting with chronic Monteggia lesions with anterior dislocation of the radial head. RESULTS: Reduction of the radiocapitellar joint was successfully achieved in all patients after ulnar osteotomy and gradual correction using the Ilizarov external fixation...

BACKGROUND: Fractures of the radial neck in children have shown to account for 5-10% of traumatic elbow injuries in the pediatric population. Chronic dislocation of the radial head with concomitant fracture has been shown to result in progressive deformity and unacceptable loss of motion. METHODS: In this case report, we describe a patient who sustained a type 2 radial neck fracture with 100% displacement. The patient's clinical and surgical management will be discussed and a review of the literature is provided as it relates to this particular case...

BACKGROUND: The purpose of the present study is to evaluate the clinical and radiographic outcomes after open reduction and Z-lengthening technique with annular ligament reconstruction for the treatment of a chronic Monteggia fracture-dislocation. MATERIAL AND METHOD: The authors postoperatively investigated the clinical and radiographic outcomes for ten children with a chronic Monteggia fracture. The present study group included seven boys and three girls mean age of nine years and one month at the time of open reduction...

OBJECTIVE: Pediatric elbow trauma is challenging because of the complex nature of the growing skeleton. The objectives of this article are to review the anatomy and radiographic landmarks and to discuss common acute and chronic injuries sustained. CONCLUSION: Radiographic evaluation of elbow trauma in the acute setting requires a firm understanding of developmental anatomy, radiographic landmarks, and the common injury patterns. Both radiography and MRI are vital tools for diagnosing chronic elbow overuse injuries in adolescent athletes...

OBJECTIVE: The purpose of this study was to report the long-term follow-up results of chronic Monteggia fractures treated with angulation-translation osteotomy of ulna and closed reduction of the radial head. DESIGN: Retrospective. SETTING: Level 1 trauma center. PATIENTS: We retrospectively reviewed 10 missed Monteggia fractures in children. The mean age of the patients was 7.5 years (range, 6-10 years), and there were 2 girls and 8 boys...

PURPOSE OF THE STUDY: To review the current methods of operative management of post-traumatic chronic radial head dislocation in chronic Monteggia lesions in children. MATERIAL AND METHODS: Post-traumatic chronic dislocation of the proximal radius usually occurs following missed or ineffectively treated Monteggia fractures. The radial head is usually dislocated anteriorly. We performed open reduction of the radial head, reconstruction of the annular ligament and corrective osteotomy of the ulna in eleven patients...

OBJECTIVES: We evaluated the results of indirect reduction of the radial head via a circular external fixator in pediatric patients with unilateral chronic radial head dislocation. METHODS: Three male patients (mean age 6.3 years; range 5 to 8 years) with chronic radial head dislocation underwent ulnar lengthening using a circular external fixator for indirect reduction of the radial head. None of the patients had radiographic evidence for deformity of the radial head, dysplasia of the capitellum, or osteoarthritic changes...

Chronic dislocation of the radial head in children due to undiagnosed Monteggia's lesion is uncommon. Although it can initially be asymptomatic pain, restriction of movement and secondary arthritic changes may develop as the child grows. The treatment of chronic radial head dislocation remains controversial varying from benign neglect to surgical reduction. Only five chronic lateral Monteggia's lesions have been described with variable surgical results associated with redislocation. A case of chronic post-traumatic lateral dislocation of the radial head in a child treated with ulna osteotomy rigidly fixed and reattachment of the annular ligament is presented...

BACKGROUND: The goal of this retrospective review was to characterize the spectrum of surgical admissions to a tertiary hospital specializing in musculoskeletal conditions in children and adolescents in Nepal. METHODS: We reviewed hospital records from 1996 to 2006 to categorize all major surgical procedures. Additional information collected included diagnosis, patient age, gender, and home district. RESULTS: Of 7,556 major surgical procedures performed from 1996 to 2006, 91% could be placed within the following categories: congenital (n = 2,984; 38%), burn contracture (n = 1,400; 19%), posttraumatic (n = 1,047; 14%), neuromuscular (n = 750; 10%), and infection (n = 731; 10%)...

Posttraumatic deformities with need for surgical correction are rare and demanding in the pediatric population. The consequences of a bad outcome may last a life time. The best prevention of deformities around the elbow joint is proper initial treatment. The most common deformities are cubitus varus, cubitus valgus, chronic dislocation of the radial head and pseudarthrosis of the radial condyle. In contrast to the wide spread opinion to await the effect of the further growth, the deformity should be treated contemporarily to the underlying injury...

BACKGROUND: Chronic (neglected) radiocapitellar joint dislocation is one of the feared complications of Monteggia fractures especially when associated with subtle fracture of the ulna bone. Many treatment strategies have been described to manage chronic Monteggia fracture and the need for annular ligament reconstruction is not always clear. The purpose of this study is to highlight the management of missed Monteggia fracture with particular emphasis on utility of annular ligament reconstruction by comparing the two groups of patients...

PURPOSE: The treatment of an unrecognized Monteggia lesion continues to pose a therapeutic challenge, as evidenced by the variety of surgical techniques described. Moreover, there are high complication and redislocation rates following surgery. This report concerns a surgical technique to reduce a chronic dislocation of the radial head utilizing an ulnar osteotomy and internal fixation. METHODS: Six consecutive cases of missed Monteggia lesions were treated in our institution between August 2001 and September 2003...