J Korean Soc Surg Hand.  2014 Jun;19(2):65-69. 10.12790/jkssh.2014.19.2.65.

Acute Traumatic Irreducible Anterior Dislocation and Fracture of the Radial Head in an Adult

• Bae SW
• Choi YS
• Kim HS
• Song BY

• KMID: 2097611
• DOI: http://doi.org/10.12790/jkssh.2014.19.2.65

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.

Keyword

Radial head; Fracture; Irreducible anterior dislocation; Open reduction

MeSH Terms

Adult*
Dislocations*
Head*
Humans
Olecranon Process
Ulna

Figure

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

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  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.

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  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.

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

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  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.

Reference

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