Zamzam Mohamed M, Bakarman Khalid A
Orthopedic Department, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, KSA.
J Taibah Univ Med Sci. 2021 Oct 16;17(3):529-532. doi: 10.1016/j.jtumed.2021.09.005. eCollection 2022 Jun.
In children, traumatic radial head dislocation (RHD) is usually associated with ulnar fracture or deformation as reported in a Monteggia injury or its Monteggia variant. Isolated traumatic RHD is extremely rare and exceptional. Traumatic RHD is frequently missed on initial radiographs, particularly if it is isolated. The management of missed RHD is challenging and remains controversial. We report a Case of chronic post-traumatic RHD in a three-year-old child treated with open reduction and reconstruction of the annular ligament. The child's elbow was stable during the follow-up, without swelling or deformity, and the elbow function was normal. The injury of the reported case does not belong to any lesion described in the Monteggia-variant classification, which might explain the reason for missing the associated dislocation. The authors recommend urgent open reduction when a chronic RHD is diagnosed and annular ligament reconstruction, particularly when the open reduction is unstable.
在儿童中，如孟氏骨折损伤或其变异型中所报道的那样，创伤性桡骨头脱位（RHD）通常与尺骨骨折或畸形相关。孤立性创伤性RHD极为罕见且特殊。创伤性RHD在初次X线片上常被漏诊，尤其是在孤立性脱位时。漏诊的RHD的处理具有挑战性且仍存在争议。我们报告一例三岁儿童慢性创伤性RHD病例，采用切开复位和环状韧带重建进行治疗。随访期间患儿肘部稳定，无肿胀或畸形，肘部功能正常。所报道病例的损伤不属于孟氏变异型分类中描述的任何病变，这可能解释了漏诊相关脱位的原因。作者建议，当诊断为慢性RHD时应紧急切开复位并进行环状韧带重建，特别是在切开复位不稳定时。
