Chronic isolated radial head dislocation in adults: Technical note and literature review

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TitreChronic isolated radial head dislocation in adults: Technical note and literature review
Type de publicationJournal Article
Year of Publication2021
AuteursBordet A, Le Mentec O, Arcens M, Trouilloud P, Baulot E, Martz P
JournalORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH
Volume107
Pagination102829
Date PublishedAPR
Type of ArticleReview
ISSN1877-0568
Mots-clésChronic elbow dislocation, Elbow ligamentoplasty, Osteotomy of the ulna, Radial head dislocation
Résumé

Isolated traumatic radial head dislocation is exceedingly rare in adults, usually diagnosed on an emergency basis, and reduced by external manoeuvres. If the diagnosis is not made immediately, external reduction is no longer feasible. Various options have been described for treating these chronic forms, including therapeutic abstention, radial head resection and annular ligamentoplasty combined, if appropriate, with osteotomy of the ulna. In patients with incapacitating symptoms, proposing a surgical option makes sense. Here, we describe the technique developed by PM Grammont, which combines ligamentoplasty and an oblique flat osteotomy of the ulna. We used this technique in a 31-year-old male with isolated anterior dislocation of the radial head of 3 months? duration. One year after surgery, he had fully recovered range of motion in all planes. He returned to work 5 months after surgery. The promising clinical and radiological outcomes in our patient support the use of this technique in adults with chronic isolated radial head dislocation. Isolated traumatic radial head dislocation is exceedingly rare in adults, usually diagnosed on an emergency basis, and reduced by external manoeuvres. If the diagnosis is not made immediately, external reduction is no longer feasible. Various options have been described for treating these chronic forms, including therapeutic abstention, radial head resection and annular ligamentoplasty combined, if appropriate, with osteotomy of the ulna. In patients with incapacitating symptoms, proposing a surgical option makes sense. Here, we describe the technique developed by PM Grammont, which combines ligamentoplasty and an oblique flat osteotomy of the ulna. We used this technique in a 31-year-old male with isolated anterior dislocation of the radial head of 3 months & rsquo; duration. One year after surgery, he had fully recovered range of motion in all planes. He returned to work 5 months after surgery. The promising clinical and radiological outcomes in our patient support the use of this technique in adults with chronic isolated radial head dislocation. Level of evidence: IV. (c) 2021 Elsevier Masson SAS. All rights reserved.

DOI10.1016/j.otsr.2021.102829