Post-traumatic radioulnar synostosis is usually a real functional handicap. It can occur at any level between the elbow and the wrist and may be complete or incomplete.
A proximal synostosis can occur post fracture or distal biceps repair. Management always entails excision of the HO; however, there can be a recurrence of the HO. The risk of this can be lessened with perioperative radiotherapy, interposition between the resected osseous surfaces, and NSAIDs.
The anconeus can be mobilized as a vascular muscle pedicle flap, proximally or distally, and be interposed between the radius and ulna at the synostosis site. Postoperative management involves physiotherapy, a CPM machine, and rotation assist splints.