Abstract
Dislocation of the radial head is usually associated with the fracture of the ulna (Monteggia's fracture), and isolated dislocation of the radial head is rare.
In 1994, Lincoln reported 5 cases of traumatic dislocations of the radial head associated with ulnar bowing. After his report, clinical entity of “ulnar bowing” gained widespread interest.
We experienced 5 cases of dislocation of the radial haed associated with ulnar bowing. 3 cases were boys and 2 were girls, and their ages ranged from 5 to 11 years old. All their plain X-rays showed “ulnar bowing”, and their maximum ulnar bow ranged 3.5 to 11.0mm.
The dislocations of the radial head were closely reduced in 3 fresh cases. In 2 cases with less ulnar bowing (4.0 and 4.5mm), the reduction of the radial head was accomplished without reduction of ulnar bowing. On the other hand, in 1 case with ulnar bowing of 11mm, ulnar bowing was reduced without the reduction of the radial head. As ulnar bowing reduced, the reduction of the dislocation of the radial head was achieved. After reduction of the radial head, 5mm of ulnar bowing remained.
In 2 cases with old dislocation of the radial head with ulnar bowing, no closed reduction could be obtained, and open reduction with reconstruction of the annular lifgaments was performed.
In all cases, full range of motion was more or less obtained, and re-dislocation of radial head did not occur.
We recommend the reduction of ulnar bowing firstly for patients with dislocation of the radial head accompanied with ulnar bowing of more than 5mm. For patients with ulnar bowing less than 5mm, the reduction of the dislocation of the radial head should be reduced first.
