Voluntary dislocation of the radial head

Abstract

CASE REPORT A 28-year-old right-handed man came to our hospital with snapping of his right elbow with powerful flexion. He also described an unbearable dull pain in his forearm while he attempted to write. He had practiced karate for 2 years, from the ages of 10 to 12 years, and had had episodes of minor repetitive trauma while performing the sport. However, he had never had any significant trauma to the elbow. The patient had first had dull pain in the forearm when he was 16 years old. His symptoms persisted and became more severe. When he was 22 years old he began to have difficulty writing because of worsening pain in the right forearm. The pain became so disabling that the patient had to cease all writing. The range of motion of the elbow was from 0 ~ to 145 ~ of flexion. Supination was 90 ~ and pronation was 65 ~ The carrying angle of the right elbow was normal and symmetric with that of the left elbow. Valgus instability was present on manual stress testing. The patient had voluntary anterior radial head dislocation when his elbow was flexed 90 ~ or greater against an applied resistive force to the forearm. A prominent snapping occurred with the dislocation. Spontaneous reduction of the radial head occurred when con-