A case report of recurrent annular ligament displacement in a pediatric patient.

Abstract

Background: Annular ligament displacement (ALD) is a common pediatric condition whereby the annular ligament slips over the radius and remains trapped between the radial head and capitellum. It can be reduced with relative ease by performing passive pronation or supination with concomitant pressure over the radial head. However, ALD is more likely to recur after the initial incident, concerning for both the patient and caregivers.

Purpose: This article describes the successful conservative management of a 2 year, 4 month old female patient with recurrent ALD, having occurred six times in an 8 month period.

Methods: The role of an orthosis, targeted exercises, and education for caregivers for treating recurrent ALD is discussed.

Results: At each follow up and final 18 month follow up no ALD events had occurred.

Conclusions: Previous literature discussing treatment for recurrent ALD has examined teaching caregivers to reduce the elbow at home or teaching reductions via telehealth. However, there is a dearth of research around treating the issue so recurrence does not occur. This conservative intervention demonstrates a potential avenue for treating chronic recurrent ALD to eliminate subsequent events.