Irreducible Anteromedial Dislocation of Radial Head with Biceps Tendon Interposition

Abstract

The case presents an isolated irreducible anteromedial dislocation of radial head due to biceps tendon interposition on a 14-year-old female patient. After an unsuccessful closed reduction, a lateral approach of the left elbow was carried out through Kocher's interval. Given that no pathology was found on the radiohumeral joint, the approach was extended distally. This revealed that the biceps tendon was displaced laterally around the radial neck, preventing the reduction. Once the tendon was taken back to its anatomical position, the radial head reduction was performed successfully. The patient achieved a complete functional recovery. Possible injury mechanisms are discussed, as well as the importance of identifying such a rare injury.

Figure 1

Left elbow anteroposterior (a) and lateral (b) X-ray where the medial and anterior dislocation of the radial head can be observed. No pathology is observed on the ulnohumeral joint.

Figure 2

Intraoperative view (a) and injury diagram (b). The displaced biceps tendon prevents reduction of the radial head, keeping it in anteromedial position. R: radial head, C: humeral condyle, U: ulna, and ∗: biceps tendon.