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ULNAR OSTEOTOMY FOR REDUCTION OF CHRONIC ANTERIOR RADIAL HEAD DISLOCATION IN CHILDREN

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Introduction. Chronic aquired anterior dislocation of the radial head, Bado type I Monteggia equivalent lesion is a uncommen occurence in children. We present our results of sixteen childrn treated with an angular corrective osteotomy

Material and methods. Sixteen children, mean age at the time of injury was six years and eight years at the time of surgery. Time from dislocation to diagnosis was median 30 weeks. Preoperatively decreased range of motion was detected. All children underwent angular ulnar osteotomy using Boyd-Thompson approach. The osteotomy was fixed using a single Steinmann pin. Long arm cast was applied until radiographic healing was detected.

Results. Follow-up showed all but one had successful reduction. Non-union was not detected. All children were pain free at follow up. The total flexion-extension arc of motion measured median 135 degrees. Total rotation of forearm measured median 145 degrees.

Conclusion. Correct treatment of Monteggia equivalent lesionsare demanding. Both in relation to obtaining the correct diagnosis without delay as well as the best treatment procedure. Full antebrachium X-rays are recommended in order to get exact diagnosis initially. Corrective angular ulnar osteotomy is recommened as soft tissue procedures alone is insufficient for alignment of the elbow.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.