Radial Head Dislocation

Aka: Radial Head Dislocation, Proximal Radius Dislocation

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II. Epidemiology

  1. Uncommon condition in children
  2. Differentiate from Nursemaid's Elbow (subluxed elbow)
    1. Nursemaid's Elbow is much more common in children

III. Causes

  1. Traumatic Injury dislocates radial head anteriorly
    1. Fall on an outstretched pronated arm
    2. "Bent Ulna" suggests Monteggia Fracture
  2. Congenital disorder
    1. Radial head dislocates posteriorly
    2. Radial Head Dislocation is often bilateral
    3. Other anomalies may be associated
      1. Ehlers-Danlos Syndrome
  3. Developmental Disorder
    1. Radial head dislocates posterolaterally
    2. Result of Cerebral Palsy or neurologic injury

IV. Differential Diagnosis

  1. Monteggia Fracture
  2. Nursemaid's Elbow

V. Imaging: Elbow XRay

  1. Draw line through long axis of radius
  2. Line should always pass through capitellum in any view

VI. Management

  1. Traumatic dislocation
    1. Early reduction to prevent stiffness and pain
      1. See Elbow Dislocation
    2. Surgery for old neglected dislocations
  2. Congenital or Developmental Dislocations
    1. Management not needed if:
      1. No pain
      2. Little or no functional Impairment

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