A Rare Pediatric Case of Anterior Radial Head Dislocation Associated With Volar Annular Ligament Avulsion Fracture.

An 11-year-old girl sustained an irreducible anterior radial head dislocation associated with a Salter-Harris type II proximal radial physeal injury and a volar annular ligament avulsion fracture after falling on an outstretched hand. Closed reduction was unsuccessful. During open reduction, the annular ligament was found interposed within the radiocapitellar joint, avulsed with a small bony fragment from the volar aspect of the radial notch. After ligament release, the radial head remained unstable, requiring anatomical repair using a pullout suture technique. At 1-year follow-up, the patient exhibited excellent functional recovery and a Mayo Elbow Performance Score of 100. Volar annular ligament avulsion fractures are exceedingly rare and may contribute to irreducibility in pediatric anterior radial head dislocations. Recognition of this interposition pattern is essential for planning surgical management. Anatomical repair through pullout technique can restore joint stability and function.