Treatment of chronic isolated radial head dislocation by reconstruction of annular ligament with pedicled deep fascia

Abstract

Objective To evaluate the clinical outcomes of treating chronic isolated radial head dislocation by reconstruction of annular ligament with pedicled deep fascia. Methods Ten children with chronic radial head dislocation were treated between January 2004 and January 2009. The patients varied in age from 5 to 16 years (mean 9.7 years). They were treated by reconstruction of annular ligament with pedicle deep fascia. A clinical and radiographic assessment was undertaken at follow-up. The results were rated according to the Broberg-Morrey scoring for elbow function. Results All cases were follow-up for 1 to 6 years, the average follow-up time being 2.5 years. According to the Broberg-Morrey elbow function scores, the results were rated excellent in 4 cases (40%), good in 5 cases (50%), and poor in 1 case ( 10% ). The overall satisfactory rate was 90%. The range of functional motion and carrying angle was restored in all ten patients. No complications,such as recurrent dislocation, infection, or neurovascular injury were observed. Conclusion Reconstruction of annular ligament with pedicled deep fascia in pediatric chronic isolated radial head dislocation is fundamental to obtain stable reduction of the dislocated radial head, maintain humeroradial and ulnoradial alignment, and restore elbow function. However this procedure should be considered with caution for patients older than 14 to 16 years especially when their epiphyseal plate is closed. Key words: Radius; Dislocations; Annular ligament