Mobilization of a Congenital Proximal Radioulnar Synostosis with Use of a Free Vascularized Fascio-Fat Graft*†

Kanaya, Fuminori; Ibaraki, Kunio

doi:10.2106/00004623-199808000-00012

Cited by 87 publications

(45 citation statements)

References 12 publications

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“…Surgery for all patients was performed by a single surgeon (K. Doi) for mobilization with use of a free vascularized fascio-fat graft interposition. 11 A correction osteotomy of the radius was added in the 4 cases with radial head dislocation. Correction osteotomy of the ulna was performed in case 6 ( Table 1).…”

Section: Methodsmentioning

confidence: 99%

“…1-10 Kanaya et al 11 developed a new mobilization technique using free vascularized fascio-fat graft interposition combined with correction osteotomy of the radius. Ankylosed forearms gained range of motion (ROM) with a mean postoperative rotation arc of 718, and forearm function was significantly improved.…”

Section: Introductionmentioning

confidence: 99%

“…Ankylosed forearms gained range of motion (ROM) with a mean postoperative rotation arc of 718, and forearm function was significantly improved. 11 However, accurately evaluating forearm ROM by manual examination is difficult, and evaluating the axis of rotation (AOR) using past images from radiography or computed tomography (CT) is impossible. In vivo three-dimensional (3D) motion analysis could solve these problems.…”

Section: Introductionmentioning

confidence: 99%

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In vivo three‐dimensional motion analysis of the forearm with radioulnar synostosis treated by the kanaya procedure

Oka

Doi

Suzuki

et al. 2006

Journal Orthopaedic Research

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Attempts to separate congenital radioulnar synostosis and restore forearm rotation had been disappointing until a new mobilization technique was developed by Kanaya and colleagues using free vascularized fascio-fat graft interposition. This technique provides a functional rotation arc, but postoperative forearm motion is difficult to evaluate given the inaccuracies in determining the range of motion and rotational axis using conventional x-rays or computed tomography. This study represents an attempt to analyze in vivo three-dimensional motion of the forearm with radioulnar synostosis treated by Kanaya's operation using a markerless bone registration technique. Six patients with seven postoperative forearms (six with congenital and one with posttraumatic radioulnar synostosis) underwent 3D computed tomography with the forearm in neutral, fully pronated, and fully supinated positions. Range of motion according to this method was 30 AE 188, significantly smaller than the 82 AE 298 from manual examination. Improvements in range of motion were significantly greater in cases without dislocation of the radial head (46 AE 138) than in cases with dislocation (19 AE 108). Dislocation of the radial head was also significantly correlated with an abnormal axis of rotation of the forearm. ß

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

In vivo three‐dimensional motion analysis of the forearm with radioulnar synostosis treated by the kanaya procedure

Oka

Doi

Suzuki

et al. 2006

Journal Orthopaedic Research

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“…One is the mobilization operation to separate the radioulnar synostosis and restore forearm rotation. 1,2 The mobilization operation is thought to be the best method theoretically; however, it requires a vascularized fat graft after release of the synostosis and it is often difficult to realign the radial head in the proper position in case of Cleary type III or IV cases, in which the radial head shows posterior or anterior dislocation. 2 Another surgical procedure is osteotomy to correct the forearm position that it is suitable for the patient's ADLs.…”

mentioning

confidence: 99%

Rotational Osteotomy at the Diaphysis of the Radius in the Treatment of Congenital Radioulnar Synostosis

Fujimoto

Kato²,

Minami³

2005

Journal of Pediatric Orthopaedics

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Four cases of congenital radioulnar synostosis in three patients were treated by rotational osteotomy of the distal radius. The diaphysis of the radius was osteotomized transversely, and then the forearm was supinated manually. Following surgery, the palm was immobilized in a fully supinated position by a long-arm cast. The average age at surgery was 4 years 5 months old (range 3 years 11 months to 4 years 11 months), and the average follow-up was 21 months (range 12-36 months). Bone union was obtained in all patients without any complications or correction loss. Functional improvements were achieved in all patients. This procedure is simple and safe in the treatment of congenital radioulnar synostosis.

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“…Materials that have been tried for interposition have included muscle, 6 silastic sheets, 7,8 cellophane membrane, fascia lata, nonvascularized fat, 2,14 and vascularized free adipofascial flaps. 7 The patient represented a combination of prognostic factors (age, lengthy coma from closed head trauma, and broad extent of complete synostosis) that were considered high risk for incomplete correction. Consequently, the following procedure was designed to optimize his outcome based on the existing information in the previous literature.…”

mentioning

confidence: 99%

Free Adipofascial Flap Interposition for Pediatric Posttraumatic Forearm Synostosis With Closed Head Injury

Henry¹,

Levaro²,

Smith³

2004

Annals of Plastic Surgery

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A case report is presented of a 12-year-old male after a motor vehicle accident: head injury and multiple fractures, including bilateral both bone forearm fractures. The patient developed bilateral extensive forearm synostosis that required release and interpositional free flap at 6 months postinjury. At 3-year follow-up, the patient has maintained full forearm rotation and reports unrestricted sports and other recreational activities.

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Mobilization of a Congenital Proximal Radioulnar Synostosis with Use of a Free Vascularized Fascio-Fat Graft*†

Cited by 87 publications

References 12 publications

In vivo three‐dimensional motion analysis of the forearm with radioulnar synostosis treated by the kanaya procedure

In vivo three‐dimensional motion analysis of the forearm with radioulnar synostosis treated by the kanaya procedure

Rotational Osteotomy at the Diaphysis of the Radius in the Treatment of Congenital Radioulnar Synostosis

Free Adipofascial Flap Interposition for Pediatric Posttraumatic Forearm Synostosis With Closed Head Injury

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