Abstract
BackgroundCongenital proximal radioulnar synostosis is the most common congenital disease of the elbow joints and forearms.MethodsThis was a prospective study of 12 consecutive children (14 forearms) who presented to the National Institute of Neuromotor System in Egypt between September 2012 and September 2013 with severe congenital proximal radioulnar synostosis, having a mean pronation deformity of 70.7° (range 60°–85°), and who underwent operative correction by single-session double-level rotational osteotomy and percutaneous intramedullary K-wires of both the radius and ulna. Ten forearms were type III, and four were type II according to Cleary and Omer classification. The mean age at the time of surgery was 5 years and 2 months (range 4 years and 10 months to 6 years and 5 months). They were evaluated for functional results after rotational corrective osteotomy at a mean interval of 30.4 months (range 24–36 months) by physical examination and radiographs.ResultsAll children had a mean pronation deformity correction of 59.8° (range 30°–90°) reaching a final position of 20°–30° of pronation in the affected dominant extremities and 20° of supination in the affected non-dominant extremities after osteotomy. All children showed improvement in functional activities, with no loss of correction or non-union in any child, and no circulatory disturbances, neuropathies, or hypertrophic scars.ConclusionMinimally invasive single-session double-level rotation osteotomy of the proximal ulna and distal radius with percutaneous intramedullary K-wire fixation is a safe, technically simple and efficient procedure which corrects pronation deformity.
Highlights
Congenital proximal radioulnar synostosis, a rare congenital disease, is the most common congenital disorder of the elbow joints and forearms [1]. It results in a fixed position of the forearm ranging from neutral rotation at the mid-prone position to severe fixed pronation deformity [2]
The institute provides health services to handicapped children throughout Egypt, which explains the relatively large number of cases collected from one center. The results in this group after at a mimimum follow-up of 2 years were reported in September 2015 using their medical records, and clinical and plain radiographic examinations
The Plaster of Paris (POP) cast was changed after 2 weeks to inspect the skin wound for healing
Summary
Congenital proximal radioulnar synostosis, a rare congenital disease, is the most common congenital disorder of the elbow joints and forearms [1]. It results in a fixed position of the forearm ranging from neutral rotation at the mid-prone position to severe fixed pronation deformity [2]. The aim of the study was to evaluate the results of single-session double-level rotational osteotomy and intramedullary K-wires of both the bones distal to the site of the synostosis in order to bring the forearm into an optimal functional position for improving functional abilities. Congenital proximal radioulnar synostosis is the most common congenital disease of the elbow joints and forearms
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