Rotational and shortening osteotomy at the conjoined mass in the treatment of congenital radioulnar synostosis in children / 中华骨科杂志

ABSTRACT

Objective To investigate effect of rotational and shortening osteotomy at the conjoined mass in the treatment of congenital radioulnar synostosis.Methods Fourteen cases of radioulnar synostosis in 13 patients were treated by rotational and shortening osteotomy at the conjoined mass of radius and ulna.There were 10 males and 3 females,aged from 2 to 7 years (average,3.5 years).The pronation deformity of the forearm ranged from 50° to 90° (average,82.1°).The affected limbs could not perform some activities of daily living such as eating by holding a bowl,cleaning genitals and buttocks,turning on the global door knob,turning a key in a keyhole,and accepting objects in the palm.The operation was done through Boyd approach,and the proximal interosseous membrane of forearm was identified and released.The conjoined mass of radius and ulna was cut and shortened about 0.5 cm,then the distal part of forearm was rotated to neutral position or 10° to 20° of supination.Finally two parts of osteotomy were closed and fixed by crossing Kirschner wires which were removed 8 to 16 weeks after operation when reunion had been achieved.Results The average correction of pronation deformity of the forearm was 90.7°.No ischemic contracture of the forearm and incision infection occurred.And bone union was achieved in all patients.The parents and children were satisfied with improvement of deformity and function of the affected limbs.All patients were followed up for 14 to 88 months (average,35.7 months),and there was no loss of correction.Conclusion Rotational and shortening osteotomy at the conjoined mass of radius and ulna is an effective method for treating congenital radioulnar synostosis,which can significantly improve deformity and function of the affected limbs,and decrease risk of ischemic contracture of the forearm after operation.