Date: Mon, 3 Jul 2000 19:24:02 +0100
From: samir chhabra
Subject: Displaced radial head fracture
A 29 year old rt handed lorry driver and deliverer of heavy parcels had a fracture of his left radial head 3 weeks back.
At 7 days following the injury
Symptoms: pain, and restriction of movement. He also had discomfort at the distal radioulnar joint though there was no clinical or radiological evidence of DURJ subluxation. Following a local anaesthetic injection in the elbow the pain disappeared but his forearm remained in neutral position with 15 deg. of supination and 20 degrees of pronation.
I did an open reduction and Herbert screw fixation. On table before opening the # there was a block to pronation and supination to the same extent as noticed preop. (Post op films:radial head2)
One week following surgery:
His pain returned and again could not move his forearm at all, stuck in neutral position. Repeat x-rays confirmed the suspicion that the fixation had failed and the fragment had displaced again. His pain at the DURJ has subsided.
What do I do now?????
According to myself, my options are: