Isolated posterior dislocation of the radial head in an adult.

AK Negi, MD Pestonji, S Iyer 
 Dept of Orthopaedics, TN Medical College, Bombay, Maharashtra.

Correspondence Address:
A K Negi
Dept of Orthopaedics, TN Medical College, Bombay, Maharashtra.

Full Text

::   Introduction

Isolated posterior dislocation of the radial head without an associated fracture of the uina in an adult in a very rare injury[1].

::   Case report

A 25-year-old female reported to the emergency room for complaints of pain and swelling of the left elbow following a vehicular accident. An X-ray of the left elbow was reported as normal. The elbow was immobilized in a plaster slab.

When the same radiograph was reviewed 3 days later on a follow-up visit to the out-patient department, an isolated posterior dislocation of the radial head was noted. (See [Figure:1]) A fresh X-ray taken on that day showed the radius to be relocated.

On examination, the elbow joint had full range of movement but on supination, the radial head dislocated out of its normal position leaving a palpable hollow. On pronating the forearm, the head of the radius got reduced with a click. Examination of other joints revealed that patient had no unusual laxity of the soft tissues as seen in conditions like Ehier - Danlos syndrome. As the head of radius was reduced on pronating the forearm, the elbow was immobilized in full pronation and 90? flexion for 4 weeks. The end result was a normal elbow with full range of movement.

::   Discussion

Isolated posterior dislocation of the radial head without an associated fracture in an adult is an extremely rare injury. Though it has been described often[1], it has been reported only once[2]. Earlier reports of radial head dislocation have been associated with either fractures of the ulna[3], or when isolated, restricted to children[4] or adolescents[5].

::   Acknowledgment

The authors thank the Dean, BYL Nair Hospital for allowing access to the patient's records and permission to publish the same.

References