Radial head button holing: a cause of irreducible anterior radial head dislocation

“Buttonholing” of the radial head through the anterior joint capsule is a known cause of irreducible anterior radial head dislocation associated with Monteggia injuries in pediatric patients. To the best of our knowledge, no report has described an injury consisting of buttonholing of the radial hea...

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Bibliographic Details
Published in:Skeletal radiology 2016-10, Vol.45 (10), p.1449-1452
Main Authors: Shin, Su-Mi, Chai, Jee Won, You, Ja Yeon, Park, Jina, Bae, Kee Jeong
Format: Article
Language:English
Subjects:
Adolescent
Bone Malalignment - diagnostic imaging
Case Report
Children
Diagnosis, Differential
Elbow Joint - diagnostic imaging
Elbow Joint - injuries
Female
Humans
Imaging
Injuries
Joint Dislocations - diagnostic imaging
Magnetic Resonance Imaging - methods
Medicine
Medicine & Public Health
Nuclear Medicine
Orthopedics
Pathology
Radiology
Radius - abnormalities
Radius - diagnostic imaging
Radius - injuries
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Summary:“Buttonholing” of the radial head through the anterior joint capsule is a known cause of irreducible anterior radial head dislocation associated with Monteggia injuries in pediatric patients. To the best of our knowledge, no report has described an injury consisting of buttonholing of the radial head through the annular ligament and a simultaneous radial head fracture in an adolescent. In the present case, the radiographic findings were a radial head fracture with anterior dislocation and lack of the anterior fat pad sign. Magnetic resonance imaging (MRI) clearly demonstrated anterior dislocation of the fractured radial head through the torn annular ligament. The anterior joint capsule and proximal portion of the annular ligament were interposed between the radial head and capitellum, preventing closed reduction of the radial head. Familiarity with this condition and imaging findings will aid clinicians to make a proper diagnosis and fast decision to perform an open reduction.
ISSN:0364-2348
1432-2161
DOI:10.1007/s00256-016-2451-2