Isolated Posterior Dislocation of the Radial Head in the Adult: An Injury not to be Missed

Abstract

Introduction: Isolated radial head dislocation in the adult is a rare and frequently missed traumatic injury. It is most commonly seen in children as a radial head subluxation. It should be diagnosed and treated without delay to avoid long-term sequelae to the joint. Case Presentation: A 22-year-old male presented to the Emergency Department complaining of persistent pain in his right elbow after a fall one week before. He had been diagnosed with an elbow sprain and arrived to our hospital using an above-elbow cast placed. The radiological evaluation revealed a posterior dislocation of the radial head without associated fractures. The patient was submitted to closed reduction followed by a cast immobilization. The follow-up weeks later showed a full and painless elbow range of motion. Discussion: Isolated posterior dislocation of the radial head in the adult is an infrequent injury, with only a few cases described in the literature. Therefore, a delay in diagnosis of a traumatic radial head dislocation in the absence of a concurrent ulnar fracture may occur. The case presented illustrates how easily the injury can be missed in the first medical evaluation. It also shows how a timely closed reduction can reestablish the joint’s full range of motion. Delay in treatment usually requires open reduction and may result in a poor functional outcome. Conclusion: A high index of suspicion is essential for the diagnosis of isolated posterior dislocation of the radial head. This clinical case demonstrated that early diagnosis and prompt treatment can successfully repair the injury and prevent functional disability of the elbow joint.