Congenital radio ulnar synostosis, analysis of functional outcome using double rotation osteotomy and osteotomy at synostosis site

Abstract

Aim: To evaluate the functional outcome using double rotation osteotomy and osteotomy at synostosis site in congenital radio ulnar synostosis Materials and methods: A prospective study has been done in Institute of child health and hospital for children, Egmore, Chennai for congenital radio ulnar synostosis. There were 11 females and 9 males of which 7 were bilateral CRUS. Cases were classified using cleary omer classification and pre op deformity measured and operated. Mean pre op hyperpronation deformity was 72° (range 55° to 85°) Results: All the children showed appreciable improvement and their parents were happy about the outcome achieved and improvement in day to day activities. Mean post-operative supination achieved is 20° (range 12° to 35°). Conclusion: The need for surgical management present in congenital radio ulnar synostosis in specific indications like bilateral hyperpronated deformity with restriction of supination which is not compensated by shoulder. So achieving 20°-25° of supination is our aim. This can be achieved by gradual osteotomies. To start with Initial osteotomy at the synostosis site, If the required supination is not achieved second osteotomy can be done at distal 1/3rd shaft of radius, Double osteotomy at both radius and ulna can be reserved as a choice for older children with bilateral hyperpronation deformity