Management of posttraumatic metadiaphyseal radioulnar synostosis

Posttraumatic radioulnar synostosis results in functional loss of forearm rotation. Treatment preference is to excise the synostosis when associated fractures have healed or when the process is radiographically static. Interposition material is used in the region of the proximal radioulnar joint or when the medullary canal of the radius or ulna is breached. Irradiation is limited to lesions at or proximal to the radial tuberosity. Postoperative management includes resting splint that holds the extremity in the extremes of forearm rotation, and intermittent active and passive range of motion exercises. Anti-inflammatory medications are used only during hospitalization. Results have shown a good functional arc of pronosupination, and no recurrence, especially when the process is limited to the midforearm.