Child 8 years …. trauma from 1 month with radial head dislocation ….now neglected dislocation with medial elbow instability due to loss of lateral support ….the patient needs radial head reduction and annular ligament reconstruction .
Skin incision .
Dissection and expose of elbow capsule
Incise of elbow capule and expose of dislocated capitelloradial joint .
Debridement of ruptured annular ligament .
Palmaris longus as tendon graft .
Stabilize of one end of tendon graft with the ulna .
Roll graft around radial neck and reduce radial head in its place and stabilize it with k wire from capitellum to radial head with the elbow in 90 degrees position.
Tight the graft around radial neck and suture it on itself .