Dear Friends
Requesting opinions. 26 year old school teacher- history of fall down the stairs. 2 months ago. She sustained # radial head and was operated in a govt hospital and then done physiotherapy.
Examination shows a lateral healed scar and ROM elbow is 70- 95 degrees . supination = 20 degree short of full and pronation =20 degree from mid-prone position.
x-rays shows radial head antero medial to olecranon and myositis of the elbow anteriorly.
Pt [ naturally] wants her ROM improved. I have asked her to do strictly active elbow mobilization for one month. If it does not improve I plan to do an arthrolysis- Can this be done through TRAP approach[ that is posterior ]? Does she need a fixator to assist in mobilization? Does the radial head need excision?
Attaching x-rays
Looking forward to opinions
DR C CHERIAN KOVOOR
KOCHI
INDIA