Angulating-Distraction Ulnar Osteotomy and Interpositional P
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Open reduction of radial head associated with open wedge ulnar osteotomy with or without annular ligament reconstruction is presently the most widely used treatment for long- standing traumatic dislocation of the radial head, independently of age, in the absence of osteoarthritis remodeling, and should preferably be performed within 1 year of trauma. An osteotomy of the ulna with over-correction and elongation aims to maintain the reduced position of the radial head through the stabilizing action of the interosseous membrane. The technique requires removal of the scar tissue interposed in the radiohumeral joint, and its success depends on the absence of deformity of that joint and the avoidance of excessive pressure on the radial head after the operation. We present a case of the neglected post-traumatic monteggia lesion in a child treated with angulating-distaction ulnar osteotomy with allograft bone wedge interposition and open reduction of the dislocated radial head without annular ligament reconstruction.

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