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Updated: May 21 2021

Congenital Radial Head Dislocation

4.2

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Images
https://upload.orthobullets.com/topic/6069/images/Xray - lateral - colorado_moved.jpg
https://upload.orthobullets.com/topic/6069/images/congenital dx of radial head.jpg
  • Introduction
    • Congenital radial head dislocation
      •  can be differentiated from traumatic dislocation by
        • bilateral involvement
        • hypoplastic capitellum
        • convex radial head
        • other congenital anomalies
        • lack of history of trauma
        • difficult to reduce
  • Epidemiology
    • Incidence
      • rare
        • < 1 per 100,000
    • Anatomic location 
      • Posterior dislocation (~70%) more common than anterior (15%) and lateral dislocation (15%)
      • bilateral in the majority of cases 
  • Etiology
    • Pathoanatomy
      • almost always posterior dislocation of radial head
      • often combined with bowing of the radius
      • the radius often appears too long compared to the ulna
    • Associated conditions
      • may have concurrent congenital anomalies
  • Anatomy
    • Elbow Anatomy & Biomechanics
  • Presentation
    • Symptoms
      • patients often asymptomatic
      • limited elbow ROM
    • Physical exam
      • radial head prominence
      • can have limited elbow ROM
        • especially in extension and supination
        • usually painless
  • Imaging
    • Radiographs
      • radial head posterior to capitellum
      • radial head can be large and convex ("dome" shaped)
      • radius is short and bowed
  • Treatment
    • Nonoperative
      • observation
        • indications
          • first line of treatment
    • Operative
      • radial head resection
        • indications
          • usually done in adulthood if patient has
            • significant pain
            • restricted motion
            • cosmetic concern of elbow
        • outcomes
          • reduces pain
          • may improve some elbow ROM
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