RESUMO
Background: There is a controversy as regard treatment of chronic dislocation of the radial head in children. Treatment varies from watchful waiting, open reduction with or without annual ligament reconstructions, open reduction with or without ulnar or radial osteotomy and excision of the radial head. Purpose To evaluate our results of open reduction and annular ligament reconstruction, using triceps aponeuosis
Patients and Methods: Nine elbows [4 traumatic, 2 congenital, 2 following brachial plexus injuries, one following multiple osteochondromas] in nine children with chronic radial head dislocation were treated with open reduction and annular ligament reconstruction using triceps apponeurosis. There were six girls and three boys. Their mean age at the time of surgery was 6 years 8 months [range: 3 years 9 months to 9 years 1 month]. Radial osteotomies were needed in 3 cases. Clinical and radiological evaluations were done according to Kim's elbow scoring system
Results: Initial postoperative radiographs showed anatomic reduction of radial head in all cases however during follow up two redislocations were encountered. Mean follow up period was 3 years 4 months [range: 1 year 2 months to 4 years 5 months]. Cases were graded excellent in 5 patients, good in one, fair in one and poor in two patients
Conclusion: Open reduction and annular ligament reconstruction ensure stable radial head in cases of chronic dislocation of the radial head however congenital dislocation needs careful approach