Post-traumatic radio-ulnar synostosis treated by surgical excision and adjunctive radiotherapy

The management of three cases of traumatic radio-ulnar synostosis involved surgical excision of the synostotic bone followed by radiotherapy. Irradiation was commenced on the first postoperative day and was continued daily. The first patient received 20 Gy midline in 10 fractions and the second and third patients 10 Gy in five fractions. No acute side effects were observed. All three patients regained a good, functional range of forearm rotation with no evidence of recurrence of the synostosis after 2 years. This method of treatment is recommended as an alternative to other adjunctive therapies including interposition of material such as silicone sheet between the bones or peri-operative pharmacological suppression.