Mid- to long-term outcomes after surgical treatment of chronic anterior dislocation of the radial head in children.

Abstract

To evaluate the mid- to long-term clinical and radiographic outcomes after surgical treatment of chronic anterior dislocation of the radial head in children. Open reduction was performed in 16 children (mean age, 9.3 years [range, 2.6-13.6 years]) with chronic anterior dislocation of the radial head. Twelve patients had a history of preceding injuries, with a mean interval between injury and surgery of 24 months (range, 2-86 months); 4 patients did not have injuries. Eight patients who had undergone reduction within 16 months were treated by open reduction and ulnar osteotomy. The other 8 patients who had not sustained trauma or had been injured >2 years previously required either annular ligament reconstruction or radial shortening in addition to ulnar osteotomy. The average preoperative Kim's elbow performance score was 77.2 ± 10.5, which significantly improved to 97.5 ± 5.8 at the final follow-up. The radial head was maintained in a reduced position in 14 patients and was subluxed in 2. Slight osteoarthritic changes of the elbow were observed in 2 patients with good reduction. The functional results were excellent in 15 and were good in 1 patient with an average follow-up of 6.5 years (range, 2.6-15.1 years). Our surgical procedure provided good mid- to long-term clinical and radiographic outcomes.