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Congenital Dislocation of Radial Head

- Discussion:
    - capitellum is hypoplastic and the radial head is ovoid or dome-shaped;
    - ulna may be short in relation to the radius;
    - in about 1/3 of patients there will be an additional anomaly of the upper extremity, and in about 1/3, there will be an anomaly in other 
           parts of the body;
           - an isolated congenital dislocation of the radial head is uncommon;
    - pts are often asymptomatic despite sl loss of extension and supination;

- Exam:
    - pts are often asymptomatic (as in this case) despite the slight loss of extension and supination;
          - activities requiring full supination may be difficult;
    - radial head prominence will be noted in many patients;

- Radiographs:

- Non Operative Treatment:
    - treatment is directed to alleviating pain, increasing motion, and improving appearance;
    - if pt is doing well, recommended treatment is observation;

- Operative Treatment:
    - excision of radial head is contraindicated in a skeletally immature pt, but this may be option if the patient develops pain as adult;
          - less than 5-10 % of patients will have pain severe enough to warrent surgery, but in this group, excision of the radial head will 
                 afford significant pain relief;
    - excision of the radial head is not expect to improve range of motion

Anterior dislocation of the head of the radius. McFarland B. Br J Surg. 1936;24:41-49. 

Excision of the radial head for congenital dislocation.

Anterior dislocation of the radial head in children.

Congenital radial head dislocation.

Congenital dislocation of the radial head: Spectrum and natural history.