The Journal of Bone and Joint Surgery, Vol 61, Issue 5 738-743, Copyright © 1979 by Journal of Bone and Joint Surgery, Inc
Congenital radio-ulnar synostosis: surgical treatment
WT Green and MA Mital
The results of an operative approach to the problem of radio-ulnar
synostosis were assessed in thirteen patients, ten to twenty-five and
one-half years after the procedure was performed. We concluded that in a
patient with bilateral synostosis one hand, the one not used in writing,
should be shifted to a position of 20 to 35 degrees of supination. With one
hand in this position, the other may be left in considerable pronation.
Often after such a shift it is not necessary to rotate the second arm.
However, if the pronation is marked in the second forearm, and if function
is impaired unduly by this position, surgical correction is indicated. The
arm should be placed in a position of 30 to 45 degrees of pronation. In
unilateral radio-unlar synostosis, the ordinarily ideal position of the
radius is between 10 and 20 degrees of supination. In an adult, the
patient's occupation should be considered in deciding on the rotatory
positions of the forearms. We usually prefer a method of transverse
osteotomy through the conjoined mass of the radius and ulna. Careful
observation of the effect on the vascular status of the limb during and
immediately after surgery is important.
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