Idiopathic distal radioulnar synostosis

Shoham, Yaron; Gurfinkel, Reuven; Sagi, Amir

doi:10.3109/2000656x.2012.754626

Cited by 5 publications

(2 citation statements)

References 9 publications

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“…5 This ossification limits the development of the radius along the longitudinal axis of the forearm. 6 In the presence of a malformation, the closing of the epiphysis also may have contributed to the occurrence of the valgus deformity as well as dislocation of the radial head observed in this patient. In support of this theory, preoperative DR showed that the fusion site was at the original location of the proximal radialis epiphysis.…”

Section: Discussionmentioning

confidence: 76%

Type 4 congenital proximal radio-ulnar synostosis mimicking as malunited radial neck and deformed radial head with insidious onset extension block: a case report and results after excision

Arora

Jagtap²,

Jain³

et al. 2022

Int J Res Orthop

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<p class="abstract">Proximal radio ulnar synostosis is a rare entity presenting with restriction of supination and pronation. Among the various types, type 4 variety is even more-rare and its presentation, can pose a diagnostic challenge specially, if with history of trauma. Radiologically, it is usually overlooked as a malunited radial neck and therefore needs thorough evaluation. We presented a case of a 15-year-old male who complains of new onset extension block following trauma, with chronically restricted supination and pronation. History suggested the restriction in supination and pronation since birth, and the extension block occurring de novo. Radiographs and CT scan of the elbow revealed proximal radio-ulnar synostosis and anteriorly dislocated, mushroom-shaped radial head, misleading and mimicking like an old, neglected and malunited radial neck fracture with a deformed radial head. The family insisted to not address the restriction of supination pronation but, asked for solution to more disabling extension block. Thus, patient was managed with open procedure, involving radial head-neck excision and removal of malformed radial head. At 1-year follow-up, the child has a well-reduced and stable elbow joint with a functional range of flexion and extension movements with restricted supination and pronation. Type 4 congenital radio ulnar synostosis not only leads to conventionally known restriction of supination pronation but also give rise to extension block de novo as presented in this case. Excision of the deformed head and neck can treat the restriction in extension, however the synostosis will require various other augmented procedures.</p>

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Section: Discussionmentioning

confidence: 76%

Type 4 congenital proximal radio-ulnar synostosis mimicking as malunited radial neck and deformed radial head with insidious onset extension block: a case report and results after excision

Arora

Jagtap²,

Jain³

et al. 2022

Int J Res Orthop

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“…Врожденный радиоульнарный синостоз (ВРУС) -редкая аномалия развития верхней конечности, возникающая на ранних этапах эмбриогенеза в результате нарушения дифференцировки из общего перихондрия проксимальных отделов лучевой и локтевой костей [1]. Несмотря на то, что в литературе описан единичный клинический случай идиопатического дистального лучелоктевого синостоза [2], авторы предполагают, что этиология данного состояния отличается.…”

Section: Introductionunclassified

Surgical Treatment of Congenital Radioulnar Synostosis in Children: Systematic Review

Fedorova

Vissarionov

Proshchenko

et al. 2022

Traumatology and Orthopedics of Russia

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Background. Congenital radioulnar synostosis (CRUS) may have a negative impact on the function of the upper limb and cause disability. The main aim of the surgical treatment is to correct the forearm position for diminishing functional limitations. The study aimed to analyze surgical methods for correction of the pronation forearm deformity in children with CRUS. Material and methods. We analysed the age at surgery, indications for surgery, the target functional forearm position, the time of consolidation of the forearm bones, the frequency of neurovascular complications. Results. Most authors considered subjective complaints as the main indication for surgical treatment. The median age at surgery was 5.17 years (3.25-9.46). The medians of the recommended forearm positions for unilateral CRUS were 0-10 of pronation for the dominant, and 0-12.5 of supination for the non-dominant limb; with bilateral cases 0-17.5 pronation for the dominant and 0-12 supination for the non-dominant limb. Median of the osteotomy consolidation time varied from 6 to 8 weeks. The maximal time of forearm bone consolidation was significantly higher (p=0.024) in the group with osteotomies through the synostosis . Though the target forearm position was achieved in all cases, the number of complications in the proximal osteotomy group was statistically significantly different (p0.01) - the chances of neurovascular complications were 20.5 times higher (95% CI: 2.7-155.6). Conclusion. The problem of surgical treatment of children with CRUS remains relevant. Development of an algorithm regarding the need for surgical treatment and type of surgery requires further research.

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