Post-traumatic radioulnar synostosis: a retrospective case series of 10 patients in Kuwait

Azeem, Mokhtar Abdul; Al-Hojailan, Khalifa; Awad, Mohammad; Khaja, Aliaa

doi:10.1016/j.jse.2022.01.151

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…A combination of therapies has thus been utilized in the treatment of radioulnar synostosis. Triple therapy in the form of pre-operative radiotherapy, heterotypic ossification excision, tissue interposition, and post-operative indomethacin has been used successfully [ 8 ]. Adipofascial radial artery perforator flap has been used in diaphyseal synostosis in one case following the concomitant head injury and surgical fixation of the fracture [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Post-Traumatic Radio-ulnar Synostosis Managed by the Excision of the Bone Bridge and Palmaris Longus Encircling Loop over the Ulna: A Case Report

Dharmshaktu,

Yadav

2024

jocr

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Introduction: Radioulnar synostosis is an uncommon complication of forearm fractures and presents with varying degrees of restricted forearm movement. The diaphysial distal third synostosis is less common and excision of the synostosis is fraught with risk of re-ossification. Use of inert or biological interposing material has thus been accompanied with the synostosis excision and various methods have been described. There is still no consensus on the ideal treatment method. Case Report: We, hereby, report a case of a long-standing radioulnar synostosis with rotational restriction of movement. Despite the movement restriction, the patient could perform basic activities of daily living and wanted to improve the movements. The presence of diaphyseal radioulnar synostosis was conformed on the radiographs and computerized tomography scan. A volar forearm approach was used and the bony bridge was excised. The ipsilateral native palmaris longus (PL) tendon was extracted from distal wrist crease and with its proximal attachment intact, circumferentially wrapped around the ulnar raw surface as an interposing material. Apart from this, free fat was also placed at the synostosis site. In the long-term follow-up of 10 years, there was no radiological evidence of re-ossification noted. The clinical improvement was not much but the patient was performing activities of daily living with no discomfort. Conclusion: The use of an encircling loop of the native PL tendon, over the raw surface of one of the forearm bones, may be another useful method to decrease the chances of recurrence following the excision of the synostosis. Keywords: Post-traumatic synostosis, radioulnar synostosis, excision, forearm bone synostosis, heterotopic ossification, management.

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Section: Discussionmentioning

confidence: 99%

Post-Traumatic Radio-ulnar Synostosis Managed by the Excision of the Bone Bridge and Palmaris Longus Encircling Loop over the Ulna: A Case Report

Dharmshaktu,

Yadav

2024

jocr

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“…Type I with the Darrach procedure (if the synostosis is located in the distal radioulnar joint) or Sauve–Kapandji (if degenerative changes in the distal radioulnar joint and the synostosis under the pronator quadratus), types II and IIIA with synostosis excision with or without interposition graft, type IIIB with excision or replacement of the radial head, and type IIIC with radial head arthroplasty 14 . Recently, a triple therapy combination (preoperative radiotherapy, tissue interposition after heterotopic ossification resection, and postoperative adjuvant indomethacin) showed good results, preventing recurrence among 10 patients with post-traumatic radioulnar synostosis in Kuwait 15 . Early rehabilitation after the surgery is considered in the postoperative period, although a defining protocol on this is lacking 16 .…”

Section: Discussionmentioning

confidence: 99%

Proximal radioulnar synostosis following Monteggia fracture-dislocation: a case report

Khadka,

Pant,

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and importance: Radioulnar synostosis is a rare complication of forearm fracture that restricts pronation-supination. This study presents a case of proximal radioulnar synostosis in an adult male after Monteggia fracture-dislocation, who had a loss of pronation and supination movements. Case presentation: Herein, we report a case of proximal radioulnar synostosis in a 43-year-old man who presented with loss of pronation and supination of the right forearm that restricted his daily activities. He had a history of Monteggia fracture-dislocation nine months back, which was managed with open reduction and internal fixation with a dynamic compression plate. Plain radiography and computed tomography of the right forearm after nine months of operation showed an implant in situ with proximal radioulnar synostosis. Implant removal was performed and the excess fibro-osseous connection in the proximal radius and ulna was removed. Clinical discussion: Forearm injuries that affect the interosseous membrane may result in radioulnar synostosis. Trauma and treatment-related factors increase the risk of radioulnar synostosis. The fibro-osseous fusion between the forearm bones restricts the pronation and supination movements. Conclusion: Loss of pronation-supination following forearm fracture should raise suspicion of radioulnar synostosis.

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“…La cirugía o tratamiento quirúrgico está indicado según Balado y colaboradores, si se trata de un paciente con una evidente pronación que le ocasione un déficit funcional considerable que altere su calidad de vida. Se ha expuesto que en pacientes que presenten deformidades unilaterales o bilaterales con 30 a 60 grados de pronación se debe realizar una valoración individualizada de la función de la o las extremidades afectadas; y en pacientes que presenten por encima de 60 grados de pronación en una o dos de sus extremidades superiores es casi indiscutible la necesidad de una cirugía reconstructiva (16,21).…”

Section: Debido a Que En Varios Casos Documentados Se Informa Que La ...unclassified

Sinostosis Radiocubital Congénita. Reporte de caso

Sempertegui Moscoso,

Herrera Jaramillo

2023

Salud ConCienc.

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Introducción : la sinostosis radiocubital congénita es una malformación desarrollada en la vida fetal temprana, catalogada como una condición rara. Consiste en una osificación heterotópica de la membrana interósea del antebrazo que bloquea los movimientos rotacionales, limitando considerablemente la realización de actividades diarias. Posee un patrón de herencia familiar, autosómica dominante, sin predilección por el sexo y es bilateral en el 60 al 80% de los casos. En este reporte de caso se presenta un paciente varón de 5 años, de etnia indígena que reside en la ciudad de Sucúa, cantón de la provincia de Morona Santiago, diagnosticado con sinostosis radiocubital congénita bilateral desde hace 1 año. Objetivo general: realizar una actualización sobre sinostosis radiocubital congénita y reporte de un caso clínico presentado en el Hospital Básico de Sucúa. Conclusiones: la sinostosis radiocubital congénita es una enfermedad rara, difícil de identificar en los primeros años de vida. El análisis de imágenes de la fusión ósea de los extremos proximales de los huesos cúbito y radio por radiografía o tomografía computarizada actualmente es el único método validado de diagnóstico. El tratamiento quirúrgico es oportuno antes de que el infante inicie su vida escolar, debido al tiempo de recuperación y rehabilitación que requiere este tipo de cirugía. Al no existir un estándar de oro de tratamiento, al paciente se le deberá tratar de acuerdo con el grado de discapacidad que presente.

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Post-traumatic radioulnar synostosis: a retrospective case series of 10 patients in Kuwait

Cited by 4 publications

References 27 publications

Post-Traumatic Radio-ulnar Synostosis Managed by the Excision of the Bone Bridge and Palmaris Longus Encircling Loop over the Ulna: A Case Report

Post-Traumatic Radio-ulnar Synostosis Managed by the Excision of the Bone Bridge and Palmaris Longus Encircling Loop over the Ulna: A Case Report

Proximal radioulnar synostosis following Monteggia fracture-dislocation: a case report

Sinostosis Radiocubital Congénita. Reporte de caso

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