Management of Posttraumatic Metadiaphyseal Radioulnar Synostosis
Section snippets
Literature review
Studies on posttraumatic radioulnar synostosis consist of single case reports or small series and can be divided into two groups: the radioulnar synostosis related to forearm fractures and radioulnar synostosis related to biceps tendon repairs. Typical of the first group is Stern and Drury's [1] report of 87 forearm fractures treated by plating with seven radioulnar synostoses. These patients had a high degree of crush injury and five of the seven sustained head injuries. Vince and Miller [2]
Surgical technique
This description is limited to resection of radioulnar synostosis distal to the bicipital tuberosity and proximal to the distal radioulnar joint (DRUJ). In contradistinction to the elbow and wrist, this dissection is usually straightforward.
Preoperative planning requires a thorough examination of the extremity. Special attention is paid to the vascular status, the integrity of the forearm musculature, and the objective documentation of sensibility with either two-point discrimination or
Discussion
The treatment of posttraumatic radioulnar synostosis has been guided by case reports and small case series with advocates proposing both early and delayed excision followed by some type of intervention to prevent recurrence [2], [3], [4], [5]. Beingessner and colleagues [14] and Sotereanos and colleagues [6] provided good results after performing excision, within 4 months of injury. Most others suggested delaying treatment for up to 12 months [23]. A number of authors have recommended
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