PMC6942731_01
Preoperative radiographic images. The lateral radiographs show anterior dislocation of the radial head (RH) with the forearm in supination (a) and complete reduction of the RH in pronation (b).
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Plain radiographs (Figures 1(a) and 1(b)) and computed tomography (Figures 2(a) and 2(b)) performed at our clinic revealed isolated RH dislocation without deformity at the radius or ulna.
Three-dimensional computed tomography images with supinated forearm ((a) anteroposterior, (b) lateral). Isolated anterior dislocation of the RH is observed.
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Plain radiographs (Figures 1(a) and 1(b)) and computed tomography (Figures 2(a) and 2(b)) performed at our clinic revealed isolated RH dislocation without deformity at the radius or ulna.
Preoperative magnetic resonance arthrography images ((a) coronal, (b, c) sagittal). The absence of the annular ligament is observed.
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Magnetic resonance arthrography revealed the absence of the annular ligament (Figures 3(a)-3(c)).
Schematic illustrations of ligament reconstruction surgery. After creating a tunnel at the proximal ulna, the loop of a number 2 high-strength suture is advanced through the tunnel (a). Autograft and a broad high-strength suture are shuttled through the loop to reconstruct the annular ligament (b). After fixation using an interference screw, the end of the graft complex is advanced proximally and fixed using a soft anchor placed at the lateral epicondyle (c).
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We performed surgical treatment with a focus on the reconstruction of the annular ligament (Figures 4(a)-4(c)).
Ranges of motion at 1-year follow-up. Elbow extension (a) and flexion (b). Forearm supination (c) and pronation (d).
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At a 12-month follow-up examination, the patient had no pain or elbow limitation (Figures 5(a)-5(d)).
Radiographic images at 1-year follow-up. The lateral radiographs ((a) supination, (b) pronation) and T2-weighted magnetic resonance images ((c) coronal, (d) sagittal) show the reduced RH with reconstructed annular ligament.
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Plain radiographs and magnetic resonance imaging (Figures 6(a)-6(d)) showed that the reconstructed annular ligament could support the position of the RH.