Stabilizing Incomplete Reduction of the Radial Head Using a Hinged Splint: Conservative Treatment for a Monteggia Equivalent Lesion

Radial head dislocation associated with plastic bowing of the ulna is classified as a Monteggia equivalent lesion. This injury in children can be treated by closed reduction, but manipulative reduction may not completely correct plastic bowing of the ulna. We encountered two cases of incomplete reduction in which the radial head was reduced in a supination position, but redislocated during rotation from neutral to a pronation position. The patients were treated conservatively using an adjustable hinged elbow splint. Plain radiography at 6 weeks after incomplete closed reduction showed that the radial head was reduced in all positions from supination to pronation; thus, both patients had good outcomes. Our method is non-invasive and may be an option for treatment of incomplete reduction of radial head dislocation with acute plastic bowing of the ulna.