Long-term results after a free vascularized adipofascial graft for congenital proximal radioulnar synostosis with an average follow-up of 10 years: a series of four cases

Kanaya, Kohei; Iba, Kousuke; Yamashita, Toshihiko

doi:10.1016/j.jse.2016.04.009

Cited by 17 publications

(21 citation statements)

References 11 publications

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“…However, some patients might show severe pronation deformity and have difficulty in daily activities such as washing face, dressing and using chopsticks or other eating utensils 2 , 6 . Congenital PRUS is more common in males than females 7 – 10 . Bilateral involvement occurs in 60% ~ 80% of cases 11 .…”

Section: Introductionmentioning

confidence: 99%

An anatomical classification of congenital proximal radioulnar synostosis based on retrospective MRI measurement combined with radiography

Chen

Wang

et al. 2022

Sci Rep

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Existed classifications of congenital proximal radioulnar synostosis (PRUS) mainly focus on osseous changes and do not cover all types of congenital PRUS, ignoring the role and developing status of the supinator. This study aims to explore the correlation between supinator development and radiographic deformity of congenital PRUS. Pediatric patients diagnosed with congenital PRUS in two pediatric Orthopedic centers were evaluated retrospectively. MRI and radiographic images of their bilateral forearms (including normal ones) were collected. The area of supinator, extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), brachioradialis (BRAR) muscle and extensor indicis (EI) muscle were measured on each forearm. The ratios of these muscles were calculated and regarded as an indicator of the developing status of supinator muscle. Twenty-seven congenital PRUS forearms of 16 patients (average 3.45 years) were included. A new MRI & X-ray classification system was proposed to cover all types of radiographic deformity and provide a comprehensive description of supinator development. This study revealed the relation between MRI measured supinator volume and radiographic deformity of congenital PRUS. Supinator muscles were observed in all congenital PRUS cases. A novel classification was proposed, providing a more comprehensive understanding of congenital PRUS.

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Section: Introductionmentioning

confidence: 99%

An anatomical classification of congenital proximal radioulnar synostosis based on retrospective MRI measurement combined with radiography

Chen

Wang

et al. 2022

Sci Rep

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“…The postoperative range of pronation and supination in motion-preserving techniques has eventually been assessed in three studies [ 9 , 23 , 24 ]. The mean fixed deformity noted in supination and pronation was 16.1° (25° to neutral) and 40° (neutral to 80°), respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Complications were noted in 17.9% (67/374) of the cases reviewed (Table 3 ). Loss of correction and neurovascular complications in the form of transient and permanent palsies were the most common complications across the studies [ 5 , 10 , 16 , 17 , 19 , 22 , 23 , 27 , 29 , 30 ]. The only articles that reported loss of correction in the weeks after surgery (during cast immobilization) were Murase et al .…”

Section: Resultsmentioning

confidence: 99%

“…These studies reported significant failures of the surgery on follow-up. Results improved when the synostosis resection was accompanied by a free vascularized graft and by an osteotomy [ 9 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Also, note that activities that require pronation can still be performed by a supinated forearm by internal rotation, flexion and abduction at the shoulder. Considering the above factors, the ideal position is thought to be a pronation of 0–20 degrees in the dominant hand and a supination of 0–20 degrees in the nondominant hand [ 18 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

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Results after treatment of congenital radioulnar synostosis: a systematic review and pooled data analysis

Barik

Farr

Gallone

et al. 2020

Journal of Pediatric Orthopaedics B

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Congenital radioulnar synostosis (CRUS) is one of the most common congenital disorders affecting the elbow and forearm, with the forearm being fixed in a range of positions usually varying from neutral rotation to severe pronation. The aim of this study, apart from a systematic review of all surgical procedures described for CRUS, is to derive any correlation between various influencing factors, outcomes and complications. This review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses format by an electronic literature search of Ovid , MEDLINE and the Cochrane Library databases. Grading was according to the Newcastle-Ottawa scale and the Modified Coleman Methodology Score. Demographic data, surgical procedures, outcomes and complications were analyzed. Outcome data were pooled to establish means and ranges across all studies. Spearman correlations were performed. A total of 23 articles, showing a poor overall study quality (all Level of Evidence IV), met the inclusion criteria. A total of 374 forearms with a mean age of 6.7 years (2.0–18.8) were analyzed. Derotational surgeries were more commonly performed (91%) than motion-preserving surgeries (9%). The mean deformity improved from 64.8° pronation (−75° to 110°) to a mean of 2.8° pronation (−50° to 80°). In total, 17.9% of patients presented with complications. A significant correlation was noted between age and major complications, proximal osteotomies and complications, and postoperative loss of reduction and double level osteotomies as the primary treatment modality. Most of the complications occurred above the threshold of 65–70° of correction and in children 7 years and above. Surgery is essential to improve the quality of life of children with CRUS. However, each type of surgery is associated with complications, along with the respective hardware being used in rotation osteotomies. Caution is, nevertheless, warranted in interpreting these results in view of the inherent limitations of the included studies.

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Congenital Radioulnar Synostosis

Taneja¹,

Shetty²,

Ramachandran³

2021

Congenital Anomalies of the Upper Extremity

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Long-term results after a free vascularized adipofascial graft for congenital proximal radioulnar synostosis with an average follow-up of 10 years: a series of four cases

Cited by 17 publications

References 11 publications

An anatomical classification of congenital proximal radioulnar synostosis based on retrospective MRI measurement combined with radiography

An anatomical classification of congenital proximal radioulnar synostosis based on retrospective MRI measurement combined with radiography

Results after treatment of congenital radioulnar synostosis: a systematic review and pooled data analysis

Congenital Radioulnar Synostosis

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