Posttraumatic proximal radioulnar synostosis: Technique for operative resection
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Resection of a posttraumatic proximal radioulnar synostosis to gain pronation and supination of the forearm.
Posttraumatic proximal radioulnar synostosis. Resection can be performed relatively early.
Central nervous system injury constitutes a relative contraindication.
Posterior midline incision which can be extended proximally if exposure of the entire elbow is needed. Dissection and exposure of the proximal and distal ends of synostosis while protecting the surrounding soft tissue. Resection of the exostosis. Test range of passive rotation. Cauterization of bleeding bony surfaces and coverage with bone wax. No need for interpositional material.
A consecutive series of 17 patients with 18 synostoses has been reviewed. Resection was performed between 6 and 11 months post injury. Average follow-up: 32 months. One patient, who had sustained a closed head trauma, suffered a recurrence. The average supination gain was 61° (25° to 85°) and the gain in pronation amounted to 78° (40° to 90°). Using the classification system of Failla et al., the overall results were judged excellent in 16 limbs, fair in 1 and poor in 1.
Key WordsRadioulnar synostosis Classification Elbow Arthrolysis Ulnohumeral ankylosis
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