Journal List > J Korean Soc Surg Hand > v.19(2) > 1106480

J Korean Soc Surg Hand. 2014 Jun;19(2):65-69. Korean.
Published online June 30, 2014.  https://doi.org/10.12790/jkssh.2014.19.2.65
Copyright © 2014. The Korean Society for Surgery of the Hand
Acute Traumatic Irreducible Anterior Dislocation and Fracture of the Radial Head in an Adult
Sang Wook Bae, Yun Sun Choi, Hyong Suk Kim and Baek Yong Song
Department of Orthopedic Surgery, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea.

Correspondence to: Baek Yong Song. Department of Orthopedic Surgery, Eulji General Hospital, Eulji University College of Medicine, 68 Hangeulbiseong-ro, Nowon-gu, Seoul 139-711, Korea. TEL: +82-2-970-8260, FAX: +82-2-970-8254, Email: sby2409@eulji.ac.kr
Received April 07, 2014; Revised June 10, 2014; Accepted June 10, 2014.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Traumatic dislocation of the radial head without fracture of the olecranon is very rare, especially in adults. We experienced a case of irreducible radial head dislocation with fracture without involvement of ulna. Open reduction and internal fixation was performed. During surgery, brachialis was interposed between capitellum and radial head, and also interposed between the fragments at the fracture site of the radial head. At 12 months after operation, the radial head was well reduced with normal rotation.

Keywords: Radial head; Fracture; Irreducible anterior dislocation; Open reduction

Figures


Fig. 1
(A) Anteroposterior and (B) lateral radiographs of the right elbow show anterior subluxation of the fractured radial head.
Click for larger image


Fig. 2
(A, B) Preoperative 3-dimensional computed tomography image shows radial head fracture and comminuted fragment, which displaced posteriorly and distally, and anterior subluxation of radial head.
Click for larger image


Fig. 3
(A) Sagittal, proton density (PD)-weighted, fast spin echo (FSE) (repetition time [TR]/echo time [TE]: 3,310/24 msec) and (B) coronal fat suppression T2-weighted FSE (TR/TE: 4,000/52 msec) magnetic resonance (MR) images show the interposed brachialis muscle (arrows) and joint capsule (empty arrow) between anteriorly subluxed radial head (Rh) and the capitellum (Hc). (C) On axial PD-weighted FSE (TR/TE: 4,410/24 msec) MR images, the brachialis (arrow) and joint capsule (empty arrow) are also interposed between the fracture fragments of Rh.
Click for larger image


Fig. 4
Intra-operation findings show the brachialis muscle (black arrow) is interposed between the fracture fragments of radial head and radial head is anteriorly subluxed.
Click for larger image


Fig. 5
(A) Anteroposterior and (B) lateral radiographs acquired 12 months follow-up after surgery show good reduction and union state of the radial head.
Click for larger image

References
1. Watanabe K, Iwabu S, Hosoya T. Traumatic isolated anterior dislocation of the radial head in an adult: a case report. J Shoulder Elbow Surg 2005;14:554–556.
2. Sasaki K, Miura H, Iwamoto Y. Unusual anterior radial head dislocation associated with transposed biceps tendon: a case report. J Shoulder Elbow Surg 2006;15:e15–e19.
3. Upasani VV, Hentzen ER, Meunier MJ, Abrams RA. Anteromedial radial head fracture-dislocation associated with a transposed biceps tendon: a case report. J Shoulder Elbow Surg 2011;20:e14–e18.
4. Heo YM, Kim WS, Kim SH, Jeon TS, Kim SB, Oh BH. Isolated anterior dislocation of the radial head in adult: a case report. J Korean Shoulder Elbow Soc 2007;10:131–135.
5. Kong KC. Irreducible isolated dislocation of the radial head in a skeletally mature teenager. A case report. Arch Orthop Trauma Surg 1993;112:304–305.
6. Takami H, Takahashi S, Ando M. Irreducible isolated dislocation of the radial head. Clin Orthop Relat Res 1997;(345):168–170.
7. Bonatus T, Chapman MW, Felix N. Traumatic anterior dislocation of the radial head in an adult. J Orthop Trauma 1995;9:441–444.
8. Baraza N, Saithna A, Krkovic MK. Acute persistent traumatic anterior dislocation of the fractured radial head: a case report and surgical technique. J Shoulder Elbow Surg 2012;21:e5–e8.