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Congenital Radioulnar Synostosis

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Congenital Anomalies of the Upper Extremity

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Abstract

Congenital radioulnar synostosis is a rare but important congenital condition. Although most children will be able to compensate for the deformity, severe and bilateral deformities can be quite disabling. Most children will present to clinic after their parents or teachers at school notice their deformity and any associated compensatory movements. Only some of these children will have significant functional deficit. Surgical intervention is indicated for severe pronation deformities of more than 60° or significant bilateral deformities that are disabling for the child. The surgical procedures broadly involve either mobilization of the synostosis to restore forearm rotation or an osteotomy to place the forearm in a more functional position. Separation of the synostosis has historically produced poor results with loss of correction and neurovascular complications. Recent attempts at using an interposition free vascularized fascio-fat graft have produced better results. Osteotomy has been the commonly performed procedure and it can be performed at the level of the synostosis, distal radius or both radius and ulna. The Illizarov technique has been successfully used for a gradual correction. The most significant complications of surgery are compartment have syndrome and neurological deficit. Loss of correction and recurrence have also been reported.

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Authors and Affiliations

  1. Centre for Orthopaedics, The Royal London and Barts & The London Children’s Hospitals, Whitechapel Road, Whitechapel, London, E1 1BB, UK

    Tarun Taneja M.B.B.S., M.S., F.R.C.S. (Orth) & Manoj Ramachandran B.Sc., M.B.B.S., F.R.C.S. (Orth)

Authors
  1. Tarun Taneja M.B.B.S., M.S., F.R.C.S. (Orth)
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  2. Manoj Ramachandran B.Sc., M.B.B.S., F.R.C.S. (Orth)
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Corresponding author

Correspondence to Manoj Ramachandran B.Sc., M.B.B.S., F.R.C.S. (Orth) .

Editor information

Editors and Affiliations

  1. Fletcher Allen Health Care and Vermont Children’s Hospital, Departments of Surgery and Pediatrics, University of Vermont School of Medicine, Burlington, Vermont, USA

    Donald R. Laub Jr.

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Taneja, T., Ramachandran, M. (2015). Congenital Radioulnar Synostosis. In: Laub Jr., D. (eds) Congenital Anomalies of the Upper Extremity. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7504-1_9

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  • DOI: https://doi.org/10.1007/978-1-4899-7504-1_9

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  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-7503-4

  • Online ISBN: 978-1-4899-7504-1

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