Open reduction and annular ligament reconstruction for radial head dislocation

Treatment of diseases: congenital humeral head dislocation, humeral head subluxation, upper 1/3 of ulnar fracture combined with humeral head dislocation Indication The treatment of humeral head dislocation and open reduction and annular ligament reconstruction is applicable to: 1. The humeral head is freshly dislocated, but there is soft tissue incarceration, and the closure is reset. 2. The fresh dislocation of the humeral head is unstable after the closed reduction and re-dislocation occurs. Old dislocations of more than 3.3 weeks. Surgical procedure Incision The posterolateral approach of the humerus head is made from the outside of the humerus and the skin is cut along the anterior border of the elbow muscle. The elbow muscle and the ulnar wrist extensor muscle were separated and retracted to the sides. 2. Exposure and reset The humeral head was found and the subperiosteal peeling revealed clearly. Find the annular ligament, check for ligament tears, and if possible, suture, suture with silk. If suturing is not possible, remove a fascia of about 10 cm in length and about 1.5 cm in width from the outside of the thigh. Another 5 cm incision was made to reveal the posterior side of the ulna. At the upper end of the ulna, at the same level as the humeral neck, a bone hole is drilled across. The fascia strip is double folded through the bone hole, around the humeral neck, and the ends are stitched together to create a new annular ligament. complication 1. Deep sacral nerve injury, wrist drooping. 2. The forearm rotation is reduced.