Irreducible 'ulled elbow' report of two cases and review of the literature

Abstract

Subluxation of the radial head is a common injury in young children. It occurs after longitudinal traction on the extended arm with the forearm in pronation. Diagnosis is made from history and clinical presentation. Closed reduction achieved by supination and flexion or by hyperpronating the affected arm can usually restore normal anatomy satisfactorily. Rarely, it requires open reduction. There are very few cases in the literature that have required open reduction and no article shows intraoperative photographs. We present two cases of delayed diagnosis owing to an atypical clinical history that required open reduction.