Congenital radioulnar synostosis.

Area of Science:

• Orthopedics
• Pediatric Surgery
• Hand Surgery

Background:

• Congenital radioulnar synostosis is a condition causing forearm bone fusion.
• Severe cases lead to significant functional limitations, impacting daily activities like eating and object manipulation.
• Bilateral involvement or severe hyperpronation exacerbates disability.

Purpose of the Study:

• To evaluate the outcomes of derotational osteotomy for congenital radioulnar synostosis.
• To determine the optimal functional position for bilateral cases.
• To assess the complication rate associated with the surgical procedure.

Main Methods:

• Thirty-three patients with congenital radioulnar synostosis underwent derotational osteotomy.
• The majority of procedures involved fixation through the synostosis using an intramedullary wire and a transfixing device.
• Functional outcomes and complications were recorded.

Main Results:

• Eighty-two percent of patients achieved good or excellent functional results.
• The recommended optimal position for bilateral cases is 10-15% pronation in the dominant extremity and neutral in the contralateral limb.
• Eight complications occurred, with four instances of neurovascular compromise.

Conclusions:

• Derotational osteotomy is an effective surgical treatment for congenital radioulnar synostosis.
• Careful consideration of postoperative positioning is crucial for optimal outcomes in bilateral cases.
• The procedure carries a risk of complications, including neurovascular issues, necessitating careful surgical technique and patient selection.