Excision of the head of the radius in a child should not be done because :
**Core Concept:** Radial head fracture is a common pediatric forearm fracture, and the treatment options include closed reduction and immobilization or open reduction and internal fixation. In some cases, the head of the radius may be avulsed from the capitellum, leading to a "displaced radial head fracture." In such cases, open reduction and internal fixation may be necessary to restore proper articulation and function.
**Why the Correct Answer is Right:** In children, the epiphysis (growth plate) of the radius is located at the capitellum, where the head of the radius articulates with the olecranon process of the ulna. When the radial head is avulsed, it can damage the growth plate, leading to growth disturbances and limb-length discrepancies. Furthermore, if the radial head is not reduced and fixed, the radial head can become unstable, leading to a post-reduction subluxation or dislocation, compromising the radial head's function and potentially causing elbow instability.
**Why Each Wrong Option is Incorrect:**
A. This option is incorrect because excision of the radial head does not address the underlying issue of growth disturbances and elbow instability caused by the avulsed radial head.
B. This option is incorrect because excision of the radial head does not address the potential growth disturbances and elbow instability caused by the avulsed radial head.
C. This option is incorrect because excision of the radial head does not address the potential growth disturbances and elbow instability caused by the avulsed radial head.
D. This option is incorrect because excision of the radial head does not address the potential growth disturbances and elbow instability caused by the avulsed radial head.
**Clinical Pearl:**
In children, the radial head's excision should be avoided due to the potential complications of growth disturbances and elbow instability. Instead, open reduction and internal fixation should be considered to address the avulsed radial head's underlying issues, ensuring proper elbow stability and growth potential.