Open reduction with ulnar osteotomy for chronic post-traumatic radial head dislocation in children

Abstract

Purpose: A number of surgical techniques with variable results and complications have been described for the treatment of chronic post-traumatic radial head dislocations or the missed Monteggia lesions. This study aims to evaluate open reduction of radial head with ulnar corrective osteotomy with rigid fixation with plate, without annular ligament reconstruction or repair. Methods: 11 patients were treated between 2011 and 2016, 7 were male while 4 were female, average age being 7.8 years (range 6-11.5 years). Right side was involved in 8/11. The average interval between injury and surgery was 4 months (range 2 to 11 months). Patients were followed up for mean period of 13 months (7-21 months), assessed clinically for elbow function, stability, pain, deformity and radiologically for reduction, periarticular ossifications, signs of malformation of the radial head or osteoarthritic changes. Results: All patient regained painless function of the elbow, adequate range of elbow and forearm motion with maintenance of the radial head reduction. Conclusion: Ulnar osteotomy with angulation and lengthening, provides adequate aid in reduction of radial head, without requiring additional annular ligament procedures.