Kawoosa et al. Journal of Medical Case Reports 2010, 4:344 http://www.jmedicalcasereports.com/content/4/1/344 Page 3 of 6 Figure 3 Sketch showing planning for reduction of the radial head with hyperangulation of the regenerate in the anterior- posterior planes. after surgery in a differential manner, to create length- ening and hyperangulation in two planes as planned. We followed up the progress of our patients every week with both clinical and radiologic examinations to assess the lengthening, angulation and relocation of the radial head. For our first patient, relocation of the radial head was confirmed both clinically and by radiography by the third postoperative week. Relocation took longer for our second patient, being achieved by the fifth post- operative week and involving lengthening of the ulna by 15 mm (Figure 6). Both patients were encouraged to perform range of motion exercises of the elbow, and the frame was left in place until maturation of the regener- ated bone. The ring was finally taken off at six weeks for our first patient and at 12 weeks for our second patient; for both, a protective long arm cast was applied Figure 4 Sketch showing planning for reduction of the radial head with hyperangulation of the regenerate in lateral planes. for another two weeks. The regenerated bone healed at an average rate of three weeks/cm. The radial head maintained the reduced position without annular liga- ment reconstruction (Figures 7, 8). At follow-up two years after surgery, both patients had an excellent result and 100% range of motion around the affected elbow (Figures 9, 10). Figure 5 Postoperative radiograph after application of Ilizarov fixator and ulnar osteotomy (Patient 1).