Bilateral radial head dislocations
After orthopedic consultation, surgical treatment was not recommended at that time. Therefore, a conservative approach was pursued with observation, lifestyle modifications, and over the counter anti-inflammatory medications for flare ups of pain.
After telephone follow up, the patient reports doing fairly well without surgery. He has been able to maintain his physical activity, but continues to have occasional flare ups of pain which ar controlled with over the counter anti-inflammatory medicines.
Both the orthopedist and myself agree this is a congenital bilateral radial head dislocation abnormality. There is not enough literature to support performing an elbow surgery, such as a radial head osteotomy, to try and improve pain or range of motion with this condition. The literature shows that the natural history of this condition to be benign.
Dispositon of this well-known condition is important. Most patients do well with conservative care. However, osteoarthritis may develop and is seen more commonly in posterior (compared to anterior) dislocations, and some of these do require radial head excision.
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