{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T10:53:25Z","timestamp":1782989605894,"version":"3.54.5"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AOTT"],"abstract":"<jats:p>Abstract\n\nObjectives: We evaluated the results of indirect reduction of the radial head via a circular external fixator in pediatric patients with unilateral chronic radial head dislocation.\\r\\nMethods: Three male patients (mean age 6.3 years; range 5 to 8 years) with chronic radial head dislocation underwent ulnar lengthening using a circular external fixator for indirect reduction of the radial head. None of the patients had radiographic evidence for deformity of the radial head, dysplasia of the capitellum, or osteoarthritic changes. The etiologic factors were ulnar hemimelia, brachial plexus injury, and congenital radial head dislocation, respectively. Pre- and postoperative assessment of the patients included measurements of the carrying angle, flexion-extension of the elbow, and pronation-supination of the forearm, and anteroposterior and lateral radiographs, on which the congruency of the radiocapitellar joint, the orientation and length of the ulna and radius were assessed. The mean relative shortening of the ulna was 3.2 cm (range 2.5 to 4 cm) preoperatively. Distraction was begun on the seventh postoperative day at a rate of 3x0.25 mm per day and was continued until the achievement of reduction. Upon completion of the consolidation of the distraction callus, the fixator was removed and a brace was applied for three months to prevent fracture of the regenerated bone. The patients were followed-up for a mean of 62 months (range 42 to 98 months).\\r\\nResults: Complete reduction of the radial head was achieved in all the patients within a mean of six weeks, without any loss in position and recurrence of dislocation during the follow-up period. None of the patients exhibited dysplastic or arthritic signs in the radial head at final examinations. All three patients showed improvement in the carrying angle and were satisfied with the cosmetic appearance of the elbow and the length of the upper extremity. The mean flexion-extension improved by 28.3 degrees and the mean supination-pronation improved by 31.7 degrees. The external fixators were removed within a mean of 110 days (range 90 to 135 days). The mean bone healing index was 36 days\/cm (range 30 to 42 days\/cm). The mean ulnar lengthening was 3.2 cm (range 2.5 to 4.5 cm). Before reconstruction, the patient with congenital radial head dislocation also had a bowing deformity of the ulna and, during lengthening, this deformity was corrected gradually through additional hinges to the Ilizarov frame. The patient with ulnar hemimelia had a history of shish-kabab osteotomy at another center for ulnar bowing. Considering his young age (5 years), after achievement of radial head reduction, the proximal radius was fixed to the frame and the lengthening of the ulna was continued for an additional 7 mm to prevent future redislocation of the radial head due to asymmetric growth. There were no serious complications. Two patients had minor pin track infections that resolved completely by local wound care and oral antibiotics.\\r\\nConclusion: Albeit technically demanding, chronic radial head dislocations in children can be treated by indirect reduction of the radial head through ulnar lengthening with the use of a circular external fixator. This technique has a very low complication rate.\n\n\u00d6zet\n\nAma\u00e7: Bu \u00e7al\u0131\u015fmada, tek tarafl\u0131 kronik radius ba\u015f\u0131 \u00e7\u0131k\u0131\u011f\u0131n\u0131n tedavisi i\u00e7in, eksternal fiksat\u00f6r kullan\u0131larak dolayl\u0131 red\u00fcksiyon uygulanan \u00e7ocuklarda tedavi y\u00f6ntemi ve sonu\u00e7lar\u0131 de\u011ferlendirildi.\\r\\n\u00c7al\u0131\u015fma plan\u0131: Kronik radius ba\u015f\u0131 \u00e7\u0131k\u0131\u011f\u0131 olan \u00fc\u00e7 erkek hastaya (ort. ya\u015f 6.3; da\u011f\u0131l\u0131m 5-8) ulna osteotomisi yap\u0131ld\u0131 ve radius ba\u015f\u0131n\u0131n yerle\u015ftirilmesi sirk\u00fcler eksternal fiksat\u00f6r yard\u0131m\u0131yla dolayl\u0131 olarak sa\u011fland\u0131. Hastalarda belirgin radius ba\u015f\u0131 \u015fekil bozuklu\u011fu, kapitellum displazisi veya artroz bulgular\u0131 yoktu. Etyolojik fakt\u00f6rler s\u0131ras\u0131yla ulnar hemimeli, brakiyal pleksus yaralanmas\u0131 ve do\u011fu\u015ftan radius ba\u015f\u0131 \u00e7\u0131k\u0131\u011f\u0131 idi. Ameliyat \u00f6ncesi ve sonras\u0131nda ta\u015f\u0131ma a\u00e7\u0131s\u0131, dirsek fleksiyon ve ekstansiyonu, \u00f6nkol pronasyon ve supinasyonu \u00f6l\u00e7\u00fcld\u00fc; \u00f6n-arka ve yan grafilerde radius ve kapitellum ili\u015fkisi, ulna ve radius \u015fekil ve uzunluklar\u0131 de\u011ferlendirildi. Ulnada ameliyat \u00f6ncesi g\u00f6receli k\u0131sal\u0131k ortalama 3.2 cm (da\u011f\u0131l\u0131m 2.5-4 cm) idi. Osteotomiden yedi g\u00fcn sonra g\u00fcnde \u00fc\u00e7 kez 0.25 mm h\u0131zla distraksiyona ba\u015fland\u0131 ve radius ba\u015f\u0131n\u0131n red\u00fcksiyonu sa\u011flanana kadar s\u00fcrd\u00fcr\u00fcld\u00fc. Distraksiyon kallusunun konsolide olmas\u0131n\u0131 takiben fiksat\u00f6r \u00e7\u0131kart\u0131ld\u0131 ve yeni olu\u015fan kemi\u011fin k\u0131r\u0131lmas\u0131n\u0131 \u00f6nlemek i\u00e7in \u00fc\u00e7 ay s\u00fcreyle ortez kullan\u0131ld\u0131. Hastalar ortalama 62 ay (da\u011f\u0131l\u0131m 42-98 ay) takip edildi.\\r\\nSonu\u00e7lar: T\u00fcm olgularda radius ba\u015f\u0131n\u0131n tam red\u00fcksiyonu ortalama alt\u0131 haftada ger\u00e7ekle\u015fti ve takip s\u00fcresi boyunca pozisyonu korundu. Red\u00fcksiyon sonras\u0131nda hi\u00e7bir olguda tekrar \u00e7\u0131k\u0131k geli\u015fmedi. Son de\u011ferlendirmede hi\u00e7bir olguda radius ba\u015f\u0131nda dizplazi ya da artroz bulgusuna rastlanmad\u0131. \u00dc\u00e7 hastada da ta\u015f\u0131ma a\u00e7\u0131s\u0131nda iyile\u015fme elde edildi. T\u00fcm hastalar dirseklerinin kozmetik g\u00f6r\u00fcnt\u00fcs\u00fc ve \u00f6nkol uzunlu\u011fundan memnundu. Cerrahi sonras\u0131nda dirsek fleksiyon ve ekstansiyon a\u00e7\u0131kl\u0131\u011f\u0131 ortalama 28.3 derece, \u00f6nkol pronasyon ve supinasyon a\u00e7\u0131kl\u0131\u011f\u0131 ortalama 31.7 derece artt\u0131. Eksternal fiksat\u00f6r ortalama 110 g\u00fcnde \u00e7\u0131kart\u0131ld\u0131 (da\u011f\u0131l\u0131m 90-135 g\u00fcn). Ortalama kemik iyile\u015fme indeksi 36 g\u00fcn\/cm (da\u011f\u0131l\u0131m 30-42 g\u00fcn\/cm) idi. Ulna ortalama 3.2 cm uzat\u0131ld\u0131 (da\u011f\u0131l\u0131m 2.5-4.5 cm). Tedavi \u00f6ncesinde, do\u011fu\u015ftan radius ba\u015f\u0131 \u00e7\u0131k\u0131\u011f\u0131 olan hastada ulnada e\u011frilik de vard\u0131; ulna uzat\u0131l\u0131rken Ilizarov \u00e7er\u00e7evesine mente\u015fe eklenerek beraberinde \u015fekil bozuklu\u011fu da tedricen d\u00fczeltildi. Ulnar hemimeli olan hastaya ise ba\u015fka bir merkezde ulnadaki e\u011frilik i\u00e7in \u015fi\u015f kebap osteotomisi uygulanm\u0131\u015ft\u0131. Bu hasta 5 ya\u015f\u0131nda oldu\u011fu i\u00e7in, radius ba\u015f\u0131 red\u00fcksiyonundan sonra proksimal radius da Ilizarov \u00e7er\u00e7evesine tespit edildi ve gelecekte asimetrik b\u00fcy\u00fcme sonucu radius ba\u015f\u0131n\u0131n tekrar \u00e7\u0131kmas\u0131n\u0131 \u00f6nlemek amac\u0131yla ulna 7 mm daha uzat\u0131ld\u0131. Hi\u00e7bir olguda ciddi komplikasyona rastlanmad\u0131. \u0130ki hastada g\u00f6r\u00fclen hafif tel dibi enfeksiyonu lokal yara bak\u0131m\u0131 ve antibiyoterapi ile sorunsuz olarak iyile\u015fti.\\r\\n\u00c7\u0131kar\u0131mlar: Teknik olarak zor olmakla birlikte, \u00e7ocuklarda kronik radius ba\u015f\u0131 \u00e7\u0131k\u0131klar\u0131, ulnan\u0131n sirk\u00fcler eksternal fiksat\u00f6r kullan\u0131larak uzat\u0131lmas\u0131 ve bu sayede radius ba\u015f\u0131 red\u00fcksiyonunun dolayl\u0131 olarak sa\u011flanmas\u0131 ile tedavi edilebilmektedir; ayr\u0131ca bu tekni\u011fin komplikasyon oran\u0131 \u00e7ok d\u00fc\u015f\u00fckt\u00fcr.<\/jats:p>","DOI":"10.3944\/aott.2010.2280","type":"journal-article","created":{"date-parts":[[2010,5,12]],"date-time":"2010-05-12T14:27:30Z","timestamp":1273674450000},"page":"14-19","source":"Crossref","is-referenced-by-count":11,"title":["Indirect reduction of the radial head using an external fixator to treat chronic radial head dislocations"],"prefix":"10.5152","volume":"44","author":[{"given":"Fikri","family":"Erkal Bilen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Kocaoglu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levent","family":"Eralp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3111","published-online":{"date-parts":[[2020,2,8]]},"container-title":["Acta Orthopaedica et Traumatologica Turcica"],"original-title":[],"link":[{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/download\/2346\/2303","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T10:56:53Z","timestamp":1763463413000},"score":1,"resource":{"primary":{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/view\/2346"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,8]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2010,1,1]]}},"URL":"https:\/\/doi.org\/10.3944\/aott.2010.2280","relation":{},"ISSN":["2589-1294","1017-995X"],"issn-type":[{"value":"2589-1294","type":"electronic"},{"value":"1017-995X","type":"print"}],"subject":[],"published":{"date-parts":[[2020,2,8]]}}}