Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2023; 11(18): 4334-4340
Published online Jun 26, 2023. doi: 10.12998/wjcc.v11.i18.4334
Delayed dislocation of the radial head associated with malunion of distal radial fracture: A case report
Ki Bum Kim, Sung Il Wang
Ki Bum Kim, Sung Il Wang, Department of Orthopaedics Surgery, Jeonbuk National University Medical School, Research Insitute of Clinical Medicine of Jeonbuk National University-Biomedical Research Insitute of Jeonbuk National University Hospital, Jeonju 561-756, Republic of Korea
Author contributions: Wang SI designed the case report; Kim KB performed the research; Wang SI and Kim KB analyzed the data and wrote the manuscript; and all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patients for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sung Il Wang, MD, PhD, Adjunct Associate Professor, Department of Orthopaedics Surgery, Jeonbuk National University Medical School, Research Insitute of Clinical Medicine of Jeonbuk National University-Biomedical Research Insitute of Jeonbuk National University Hospital, 567 Baekje-ro, Dukjin-gu, Jeonju 561-756, South Korea. wsi1205@naver.com
Received: February 6, 2023
Peer-review started: February 6, 2023
First decision: May 8, 2023
Revised: May 14, 2023
Accepted: May 24, 2023
Article in press: May 24, 2023
Published online: June 26, 2023
Processing time: 140 Days and 14.6 Hours
Abstract
BACKGROUND

Traumatic radial head dislocation (RHD) is a well-described injury in the pediatric population. It is usually associated with an injury to the ulna in Monteggia fracture-dislocation, although it can occur as an isolated injury. Traumatic RHD with ipsilateral radial shaft fracture has rarely been reported. Delayed RHD secondary to the malunion of an isolated radial shaft fracture is extremely rare.

CASE SUMMARY

We report a 9-year-old boy with limited pronation of the right elbow. The patient was diagnosed with delayed RHD associated with the malunion of a distal radial fracture. Since the annular ligament was disrupted with forearm rotation causing subluxation of the radial head, a modified double-strip Bell Tawse procedure was performed to reconstruct the annular ligament without corrective osteotomy for the malunited site. Four years after surgery, the angulation deformity of the distal radius was corrected with the restoration of the normal curvature of the radius. There was no recurrence of RHD.

CONCLUSION

Annular ligament reconstruction without corrective osteotomy could reduce RHD and restore the normal curve of the radial shaft in children with delayed dislocation of the radial head associated with malunion of the radial shaft. Annular reconstruction using double triceps tendon strips might be useful for maintaining a more stable reduction by augmenting anterolateral parts.

Keywords: Dislocation; Radial head; Malunion; Radius shaft; Reconstruction; Annular ligament; Case report

Core Tip: Delayed radial head dislocation secondary to the malunion of an isolated radial shaft fracture is extremely rare. Corrective wedge osteotomy was performed in all previously reported cases to restore the normal curve of the radial shaft. The authors report a case in which the normal curve of the radial shaft was restored with a modified double-strip Bell Tawse procedure without corrective wedge osteotomy.