Purpose
The aim of this study is to establish a protocol of treatment with clear indications of surgical intervention in congenital radioulnar synostosis (CRUS) and to assess the results of this protocol by performing the osteotomy through the synostosis mass.
Patients and methods
A total of 20 forearms with CRUS in 15 patients underwent surgical correction through an osteotomy of the synostosis mass according to our protocol. The mean age of the patients at surgery was 6.5 years. The synostosis mass was divided, and the osteotomy was fixed using an intramedullary wire. The average duration of follow-up was 4.2 years (3–6 years).
Results
The desired correction was achieved intraoperatively in all patients. The mean preoperative fixed pronation was 80.7° in the dominant limb, with a mean improvement of 40.7°, and 29.1° in the nondominant limb, with a mean improvement of 49.1°. All patients were extremely satisfied with the result of surgery regarding the cosmetic improvement as well as performing activities of daily living comfortably.
Conclusion
Correction of CRUS by osteotomy through the synostosis mass is a safe, easy, and efficient technique that markedly improves the child’s function. The clear guidelines set in this study on when to intervene, which forearm to correct, and how much derotation to perform help clarify confusion in literature. Because of loss of correction observed in all forearms, we recommend overcorrection by 10° than initially planned according to the protocol.