Outcomes of derotation osteotomy at synostosis site for congenital radioulnar synostosis

Abstract

Congenital radioulnar synostosis (CRUS) is rare upper limb malformation in which proximal portions of the radius and ulna fuse with each other and restricts the rotation of the forearm. In cases with severe deformity, performing activities of daily living is difficult, and a surgical intervention is recommended. We present a retrospective study including patient operated for CRUS between January 2009 and December 2017 by derotation in synostosis site. Ten patients were operated. Five was unilateral and five bilateral (only one patient was operated for both sides. Mean age was 5 years. Preoperative assessment revealed limitation of the activities of daily life in all patients with an average pronation deformity of 62o. Type III of Cleary and Omer classification was the most frequent. The average correction of the forearm angle was 54o. Nine patients were satisfied and showed improvements in the ability to perform the activity of daily life. We report one case of complication (compartmental syndrome with nonunion). In summary, CRUS is a rare deformity, frequently bilateral and more commonly seen in male patients. Indications for surgery are pronation deformity of 60o or more, bilaterality and pronation of 20o to 60o with disability. It has been reported that complications are more common in osteotomy in synostosis site.

Keywords

• radioulnar synostosis
• hyperpronation deformity
• derotation osteotomy
• synostosis site
• complications