Congenital Radial Head Dislocation: A Narrative Review of Etiology, Diagnosis, and Treatment.

Congenital radial head dislocation (CRHD) is an uncommon orthopedic anomaly affecting the elbow joint and is frequently associated with other congenital deformities. This narrative review synthesizes evidence identified through targeted searches of PubMed and Web of Science, with emphasis on peer-reviewed studies addressing the epidemiology, developmental and genetic mechanisms, diagnostic evaluation, clinical differentiation, management strategies, and treatment outcomes of CRHD. CRHD may present as either unilateral or bilateral dislocation, with posterior dislocation being the most frequently reported subtype. Frequently overlooked during childhood, CRHD often becomes clinically apparent during adolescence or adulthood through symptoms such as elbow discomfort, cosmetic prominence, mechanical symptoms, and restricted joint mobility. Diagnosis remains challenging because of its variable clinical presentation and often requires careful integration of clinical history, physical examination, and imaging findings. The pathogenesis of CRHD is multifactorial and involves complex genetic, developmental, and structural abnormalities, particularly collagen type I defects, disturbances in endochondral ossification, and disproportionate growth between the ulna and radius. Management strategies range from conservative observation in asymptomatic or minimally symptomatic patients to surgical interventions, including radial head excision, ulnar osteotomy, open reduction, and annular ligament reconstruction in selected symptomatic cases. Although surgery may provide pain relief and improve forearm rotation, it carries potential complications, including wrist pain, recurrent deformity, and redislocation. Further research is needed to refine diagnostic criteria, optimize patient selection for surgery, and improve long-term functional outcomes in patients with CRHD.