PMC6742879_01
Plain X-ray taken at the time of injury reveals a fracture of the proximal third of the ulna and anterior dislocation of the proximal end of the radius.
JOCR-9-30-g001.jpg
PMC6742879_01_JOCR-9-30-g001.jpg
F1
Her plain X-ray revealed radial head dislocation and a proximal ulnar fracture (Fig. 1).
Photograph indicating limited extension and flexion.
JOCR-9-30-g002.jpg
PMC6742879_01_JOCR-9-30-g002.jpg
F2
The patient exhibited considerably limited elbow range of motion at initial examination (flexion, 90 ; extension, -25 ; pronation, 90 ; and supination, 0 ) (Fig. 2).
(a) Anterior dislocation of the radial head surrounded by ossification. (b) Plastic deformation of the ulna.
JOCR-9-30-g003.jpg
PMC6742879_01_JOCR-9-30-g003.jpg
F3
The plain X-ray also revealed anterior dislocation of the radial head with surrounding ossification as well as plastic deformation of the ulna (Fig. 3).
Fluoroscopic image obtained post-ulnar osteotomy. Reduction of the radial head was not achieved.
JOCR-9-30-g004.jpg
PMC6742879_01_JOCR-9-30-g004.jpg
F4
Complete reduction could not be achieved using only ulnar osteotomy and straightening (Fig. 4).
Scart issue surrounding the radial head (arrow). Reduction of the radial head was achieved on removing the scart issue.
JOCR-9-30-g005.jpg
PMC6742879_01_JOCR-9-30-g005.jpg
F5
The scar tissue and annular ligament remained intact, thereby hindering complete reduction (Fig. 5).
(a and b) post-operative plain X-rays (lateral [above] and frontal view [below] views) showing reduction of the radial head dislocation on the day after angle correction to 20 byexternal fixation. The radius was lengthened by 7 mm.
JOCR-9-30-g006.jpg
PMC6742879_01_JOCR-9-30-g006.jpg
F6
The correction angle was set at 20  (Fig. 6 and 7).
The annular ligament was reconstructed using the restored triceps muscle fascia(arrow).
JOCR-9-30-g007.jpg
PMC6742879_01_JOCR-9-30-g007.jpg
F7
The correction angle was set at 20  (Fig. 6 and 7).