Evidence-Based Treatments of Congenital Radio-Ulnar Synostosis

Abstract

Congenital radio-ulnar synostosis (CRUS) is a rare disease characterized by abnormal fusion of radius and ulna resulting in limitations of supination and pronation. There are limited evidence in literature and can be found in the form of case series and case reports consisting of small number of patients. Majority of patients affected has an idiopathic cause, however, some patients do have a familial predisposition or underlying genetic condition. Treatment options are largely based on age, severity of synostosis and severity of functional restriction at presentation. Most cases are treated non-operatively as patients do compensate remarkably well by modifying day-to-day activities. The two main surgical treatments consist of either surgical resection with mobilization of synostosis or surgical derotation of forearm into a more functional position. We recommend that all patients who present with CRUJ be investigated for underlying genetic disorders. Patients should be assessed on a case-to-case basis in terms of suitability for surgical intervention based on their functional requirement and current limitations or symptoms.