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Due to the hypoplasia of the radial head or anterior and posterior dislocations, a local depression in the radial head of the normal site can be seen. Congenital radial head dislocation is rare. When the radial head dislocation takes longer, there is no evidence of ulnar fracture, and the radial head is smaller and normal than normal, and the disease should be suspected.

Basic Information

Visiting department

Pediatrics

Common locations

Elbow

Common symptoms

Bilateral elbow asymmetry, sometimes popping or restricted movement when elbow joint is extended or flexed

Contagious

no

Causes of congenital radial head dislocation

The cause is still unclear. The radial head dislocation can be forward, backward or outward.

Clinical manifestations of congenital radial head dislocation

The disease is mainly manifested as bilateral elbow asymmetry, sometimes with popping or restricted movement when the elbow joint is extended or flexed. The bending direction of the ulna is related to the type of dislocation. For example, the anterior dislocation of the radial head, the ulna is convex forward; when the radial head is dislocated, the ulna is convex backward; when the lateral dislocation is outward, the ulna is convex outward. When the radial small head is dislocated forward, the elbow flexion range becomes smaller. The dislocated radial small head can be dislocated at the elbow fossa. When the radial small head is dislocated posteriorly, the elbow joint cannot be fully straightened. head. X-ray film shows that the longitudinal axis of the radial shaft on the lateral elbow of the elbow joint does not cross the humeral head, the radial head is dome-shaped, the radial neck and the small head of the humerus form a joint, and an indentation can occur at the contact site.

Congenital radial head dislocation examination

X-ray shows radial head dislocation.

Diagnosis of congenital radial head dislocation

There was no history of trauma, and the dislocated radial head could be dislocated in the elbow. The X-ray film showed the radial head dislocation, and the diagnosis could be confirmed.

Differential diagnosis of congenital radial head dislocation

Distinguish from traumatic radial head dislocation.

Monteggia fractures, radial neck fractures, stretched elbows, and other injuries often cause traumatic radial head dislocations. Ulnar curvature is not a unique feature of congenital radial head dislocation and can occur in unreduced traumatic radial head dislocation. In congenital radial head dislocation, the humeral head is small and the radial head is oval. The ossification of the soft tissues around the radial head indicates an unreduced traumatic radial head dislocation.

Treatment of congenital radial head dislocation

Congenital radial head dislocation cannot be reduced by closure or surgery, because the indications of soft tissue have changed, and the normal articular surface between the ulna and humerus has been lost. Therefore, incision reduction and ring ligament reconstruction should not be used in childhood. Restricted forearm rotation is often the cause of functional impairment, and physiotherapy for children's enhanced exercise is the only treatment.

If pain persists into adulthood, the head and neck of the radius can be removed. Radial head resection can only be performed after growth has stopped. Compbell, Water, and Emans reported that 6 patients (8 elbows) aged 10 to 15.5 years had good results after radial head resection. Compared with previous reports, radial head resection can increase the range and Reduces elbow pain.