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Radial-Ulna Synostosis

Valentina Brioschi, Sorrel J Langley-Hobbs, Sharon Kerwin, Richard Meeson, Heidi Radke
OBJECTIVES: The objective was to describe the complications and long-term outcome associated with Kirschner (K)-wire fixation of combined distal radial and ulnar physeal fractures in six cats. METHODS: Medical records (2002-2014) of six referral institutions were searched for cats with combined distal radial and ulnar physeal fractures. Cases with complete clinical files, radiographs and surgical records were retrospectively reviewed. Long-term outcome was assessed via telephone interviews using an owner questionnaire...
June 27, 2016: Journal of Feline Medicine and Surgery
Ajay Puri, Ashish Gulia, Suman Byregowda, Vishnu Ramanujan
Primary bone tumors around the elbow represent <1% of all the skeletal tumors. Surgery with or without adjuvant therapy (radiotherapy, chemotherapy) is the treatment of choice for malignant tumors. Reconstruction of the elbow and forearm in malignant tumors is challenging as it involves a complex interplay between multiple joints which need to be stabilized for the optimal functional outcome. We describe a new technique for the reconstruction of the elbow after resection of a proximal ulna tumor with articular radio-ulnar synostosis with the creation of a single bone forearm...
April 2016: International Journal of Shoulder Surgery
(no author information available yet)
OBJECTIVE: To investigate the imaging features of humerus, radius and ulna rare malformation. METHODS: A retrospective analysis of the clinical data and image of 40 cases of humerus and the radius and ulna rare developmental deformity andadmitted to hospital affiliated to 1958 - 2014 years in The Affiliated Hospital of Hangzhou Normal University and the Third Hospital of Hebei Medical University. Take the Swanson classification as the basis, the image changes of different types of malformations are classified and summarized...
April 7, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Xavier Simcock, Apurva S Shah, Peter M Waters, Donald S Bae
BACKGROUND: Congenital radioulnar synostosis (CRUS) refers to an abnormal connection between the radius and ulna due to embryological failure of separation. Derotational osteotomy has been advocated for children with functional limitations, although historically this procedure has been associated with a 36% complication rate including compartment syndrome and loss of correction. METHODS: A retrospective evaluation of consecutive patients who underwent derotational osteotomy for CRUS at a single institution was performed...
December 2015: Journal of Pediatric Orthopedics
D C Heidenreich, Y Fourie, P Barreau
Congenital radial head sub-luxation was diagnosed in a 7-month-old, neutered male shih tzu that presented with a limb deformity and severe lameness of the right fore limb. Radiography revealed a craniolateral sub-luxation of the right radial head, which was treated by radial head ostectomy, fixation of the radius to the ulna with a screw and joint stabilisation with suture-anchors and cerclage wire. Surgical treatment followed by physiotherapy resulted in a fully functional, well-aligned and non-painful elbow...
October 2015: Journal of Small Animal Practice
Adam Diehl, Weiyi Mu, Denise Batista, Meral Gunay-Aygun
We describe a 0.73 Mb duplication of chromosome 22q11.21 between LCR-B and LCR-D and a missense mutation in a conserved C2H2 zinc finger domain of SALL4 in a cognitively normal patient with multiple skeletal anomalies including radioulnar synostosis, thumb aplasia, butterfly vertebrae, rib abnormalities, and hypoplasia of the humeral and femoral epiphyses. 22q11.21 is a common site for microdeletions and their reciprocal microduplications as a result of non-allelic homologous recombination between its multiple low copy repeat regions (LCR)...
July 2015: American Journal of Medical Genetics. Part A
L Niglis, F Bonnomet, B Schenck, D Brinkert, A Di Marco, P Adam, M Ehlinger
BACKGROUND: Fractures of the proximal ulna are rare and usually managed surgically. Strong fixation of the harware is essential to obtain good outcomes. We report our experience with pre-contoured locking plate fixation of complex olecranon fractures and present a critical appraisal of the outcomes. HYPOTHESIS: Pre-contoured locking plates provide good outcomes, but their clinical tolerance may be limited in some instances. MATERIALS AND METHODS: From September 2009 to December 2011, 28 patients were managed using a pre-contoured locking compression plate (LCP(®))...
April 2015: Orthopaedics & Traumatology, Surgery & Research: OTSR
Deepak Samson, Dominic Power, Simon Tan
We report this 47-year-old man who presented with polytrauma following a fall from a roof in March 2011. He sustained a head injury and a complex, comminuted forearm fracture. He underwent an open reduction and internal fixation of the fracture at the time of injury, but later developed a rigid type 2 diaphyseal radioulnar synostosis, with loss of forearm rotation. Synostosis excision and a radial artery perforator-based adipofascial interposition flap to prevent recurrence has resulted in a good functional outcome and no recurrence at 2...
2015: BMJ Case Reports
Karuppaiah Karthik, Ramon Tahmassebi, Adel Tavakkolizadeh, Jonathan Compson
A 32-year-old lady presented to our clinic with persistent painful restriction of her dominant forearm movements for three months after tension band wiring of olecranon. She had full elbow flexion and extension; however, her forearm rotations were restricted and painful. Investigations revealed prominent tips of the wire, eroding the radial tuberosity with heterotopic ossification between the radius and ulna. As there was no synostosis, the patient had implant exit. During surgery, before implant removal, examination under anaesthesia revealed a mechanical block of the rotation beyond 30° on pronation and supination from neutral...
August 2014: Strategies in Trauma and Limb Reconstruction
Emiko Horii, Shukuki Koh, Tatsuya Hattori, Junko Otsuka
PURPOSE: To report the effectiveness of single derotation osteotomy at the radial diaphysis for the treatment of congenital radioulnar (RU) synostosis. METHODS: Since 2000, we performed 35 radial diaphysis osteotomies on 17 boys and 9 girls younger than 9 years old (average, 5 y). The radius was cut at the midshaft and manually rotated to a neutral position. A long-arm cast was applied for 4 to 6 weeks. Complications of surgeries were recorded, and pre- and postoperative forearm position was measured...
August 2014: Journal of Hand Surgery
Reza Shahryar Kamrani, Parviz Ahangar, Mohammad Hossein Nabian, Saeed Reza Mehrpour, Leila Oryadi Zanjani
BACKGROUND: Proximal radioulnar synostosis is a complication after elbow injuries. Various treatment methods have been reported and are associated with unpredictable outcomes. In a prospective study, we evaluated the medium-term effects of proximal radial resection on wrist and elbow function and forearm rotation in 15 cases. METHODS: We treated 15 patients with posttraumatic proximal radioulnar synostosis by resection of 1 cm of the proximal radial diaphysis. On the preoperative examination and last follow-up, the Mayo Elbow Performance Score, grip force, visual analog scale for elbow and wrist score, radiographic ulnar variance changes, and elbow range of motion were measured...
June 2014: Journal of Shoulder and Elbow Surgery
G Burnei, R A Ghiță, A A Pârvan, E Japie, Ş Gavriliu, I Georgescu, T El Nayef, I Tiripa, Ş Hamei
BACKGROUND CONTEXT: Proximal congenital radial-ulnar synostosis (PCRUS) is defined by the development before birth of a bony bridge between the radius and ulna, usually at the proximal level, which blocks forearm rotation. This anomaly is rarely reported in the medical literature, because of its low prevalence, and treatment usually yields unsatisfactory results. The most commonly used surgical interventions are: forearm repositioning osteotomies with derotation of the radius and ulna, segmental resections of the middle third of the radius with muscular interposition, resection of the synostosis with the interposition of fatty tissue, tendons or fascia lata and resection of the proximal radius along with the transfer of the distal extensor carpi ulnaris tendon on the lateral edge of the radius...
2013: Journal of Medicine and Life
Gursel Saka, Necdet Saglam, Tuhan Kurtulmuş, Cem Coşkun Avcı, Fuat Akpinar, Halim Kovaci, Ayhan Celik
INTRODUCTION: The treatment goal for diaphyseal forearm fractures in adults is to restore axial and rotational stability. The treatment of these fractures with intrmaedullary locked nailing remains sparse. We therefore evaluated IM nails for treating forearm diaphyseal fractures in adults. METHODS: We retrospectively reviewed adult patients with isolated unilateral or bilateral fractures of the radius, ulna, or both, who were treated with closed or mini open reduction with a new IM nail between May 2008 and January 2012 and who were followed for a least 1 year...
January 2014: Injury
Viraj U Shingade, Rashmi V Shingade, Suresh N Ughade
BACKGROUND: For congenital proximal radioulnar synostosis, both conservative and operative treatments have been described. Most of the studies describing surgical interventions are based on subjective evaluation of the forearm function and have used severe degree of forearm pronation as an indication for surgery. This study describes a single-staged rotational osteotomy of the proximal third ulna and distal third radius. The aim of the study was to assess the utility of the described surgical procedure by subjective and objective evaluations of the forearm function...
January 2014: Journal of Pediatric Orthopedics
Ann E VanHeest, Toni E Lin, Deborah Bohn
BACKGROUND: Congenital radioulnar synostosis (CRUS) causes a spectrum of presentations, most commonly a restriction of forearm rotation. Because most of these children are not treated operatively, many are not followed clinically after the diagnosis has been made. This report describes that a subset of the Cleary and Omer type IV synostoses (anterior dislocation of the radial head) can present with a progressive block to elbow flexion that worsens with growth. The location of this synostosis allows the physis of the radial head to grow untethered...
July 2013: Journal of Pediatric Orthopedics
F Unglaub, S Manz, T Bruckner, F M Leclère, P Hahn, M B Wolf
OBJECTIVE: To stabilize the distal radioulnar joint (DRUJ) by performing dorsal capsular imbrication in patients presenting with dorsal instability. The goal was to reduce pain and prevent the occurrence of posttraumatic arthrosis. INDICATIONS: Posttraumatic dorsal instability of the DRUJ with missing block while performing translational activities in the DRUJ or subluxation while actively rotating the forearm. Cases, in which other stabilizing techniques, such as, sutures of the triangular fibrocartilage complex failed...
December 2013: Operative Orthopädie und Traumatologie
Guy Rubin, Nimrod Rozen, Noam Bor
PURPOSE: To report the method, outcome, and complications with Ilizarov external fixation for correction of congenital radioulnar synostosis with fixed forearm pronation greater than 60°. METHODS: We treated 4 patients with an average age of 11 years (range, 9-13 y). Three patients had bilateral deformity and 1 had deformity of the right forearm only. All forearms were classified as type 3 according to Cleary and Omer. Indications were severe (> 90°) bilateral pronation deformity in 3 patients, with a mean preoperative pronation deformity of 100° (range, 90° to 110°), whereas 1 patient had unilateral right forearm deformity treated for cultural reasons...
March 2013: Journal of Hand Surgery
J Trlica, I Počepcov, J Kočí, M Frank, T Holeček, T Dědek
PURPOSE OF THE STUDY: Presentation of technical experience and the clinical and functional results of intramedullary fixation of forearm shaft fractures. MATERIAL AND METHODS: Between January 1994 and December 2009, a total of 96 patients with 144 radial and/or ulnar fractures (ulna, 33; radius,15; both, 48) were treated by nailing (True/Flex®). According to the AO classification there were 22-A, 22-B and 22-C type fractures in 39 (41%), 44 (46%) and 13 (13%).cases, respectively...
2012: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
J Sonderegger, S Gidwani, M Ross
The surgical treatment of post-traumatic radioulnar synostosis is difficult. Recurrence after resection alone is a concern with poor long-term maintenance of forearm rotation. We report on the use of pedicled adipofascial flaps to prevent recurrence and facilitate maintenance of movement in six adult patients with radioulnar synostosis. Five involved the proximal radioulnar joint and one the distal radioulnar joint. In four the flap was based on the radial artery and in two on the posterior interosseous artery...
March 2012: Journal of Hand Surgery, European Volume
Bryan Hsi Ming Tan, Arjandas Mahadev
PURPOSE: To review records of 108 children with radial neck fractures and develop an algorithm for treatment. METHODS: Records of 50 girls and 58 boys aged 2 to 14 (mean, 8.7) years with radial neck fractures were reviewed. The most common injury mechanism was tripping and falling on an outstretched hand while running (n=44), followed by falling from monkey bars (n=11). Fractures were classified into grade 1 (n=25), grade 2 (n=60), grade 3 (n=16), grade 4a (n=6), and grade 4b (n=1)...
August 2011: Journal of Orthopaedic Surgery
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