Congenital dislocation of radial head
Objectives- Discuss the symptoms and physical signs of congenital dislocation of the radial head
- Discuss natural history of congenital dislocation of the radial head
- Discuss treatment of congenital dislocation of the radial head
Discussion point
- Could congenital dislocation of the radial head occur following normal limb development?
Discussion
Congenital dislocation of the radial head is an unusual congenital dislocation. It is often associated with syndromes such as nail patella syndrome, and may in some cases by genetically transmitted. When unaccompanied by other radial or systemic conditions, it is almost always bilateral. Radial shortening often accompanies congenital dislocation of the radial head. It is often not noted until age 4 or 5 at which time some limitation of motion or deformity becomes evident. Most are posterior, about 1/ 3 are anterior or lateral. The natural history is relatively benign, there is always some limitation of motion and deformity, but Echtler reported few problems in 4 untreated adults. The favored treatment approach at present is to defer any intervention until skeletal maturity, at which time resection of the radial head can improve appearance, but not motion. Resection of the radial head in a child results in regrowth of the head. Early attempts at reconstruction have been reported, but to date there has been little enthusiasm for these procedures.
References
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May 16-19, 2012 in Denver, CO
