Introduction Congenital radial head dislocation can be differentiated from traumatic dislocation by bilateral involvement hypoplastic capitellum convex radial head other congenital anomalies lack of history of trauma difficult to reduce Epidemiology Incidence rare < 1 per 100,000 Anatomic location Posterior dislocation (~70%) more common than anterior (15%) and lateral dislocation (15%) bilateral in the majority of cases Etiology Pathoanatomy almost always posterior dislocation of radial head often combined with bowing of the radius the radius often appears too long compared to the ulna Associated conditions may have concurrent congenital anomalies Anatomy Elbow Anatomy & Biomechanics Presentation Symptoms patients often asymptomatic limited elbow ROM Physical exam radial head prominence can have limited elbow ROM especially in extension and supination usually painless Imaging Radiographs radial head posterior to capitellum radial head can be large and convex ("dome" shaped) radius is short and bowed Treatment Nonoperative observation indications first line of treatment Operative radial head resection indications usually done in adulthood if patient has significant pain restricted motion cosmetic concern of elbow outcomes reduces pain may improve some elbow ROM