Introduction: Congenital proximal radio-ulnar synostosis is a rare congenital anomaly of the upper extremity which is severely disabling as it causes severe pronation deformity. So the aim of this study was to assess the efficacy of proximal radioulnar derotational osteotomy followed by internal fixation for the treatment of congenital radioulnar synostosis.
Materials and Method: Between June 2018 and April 2020, 11 patients with CRUS who underwent derotational osteotomy at the proximal radioulnar synostosis site were evaluated. There were 7 boys and 4 girls. The mean age at the time of surgery was 10.5 years (range, 2 to 13) years. The forearm was derotated to the goal position (20 degrees of supination to 10 degrees of pronation) using plates for internal fixation and plaster splints for external immobilization. Pre- and postoperative positions of the forearm were recorded; forearm function was evaluated based on the classification system proposed by Failla et al.
Results: The mean follow-up duration was 6 months. The mean initial pronation deformity was 65.0 ± 5.2 (55 to 80) degrees. The mean correction achieved was 75.27 ± 5.25 (50 to 90) degrees, resulting in a mean final position of 9.45 ± 3.25 degrees of supination (20 degrees of supination to 10 degrees of pronation). Based on the Failla classification system, 7 forearms were rated as good, 4 were rated as fair preoperatively. At the final follow-up, 9 forearms were rated as excellent and 2 were rated as good. All patients achieved bone union after 10 weeks. Post-operative period was uneventful and no complications were seen.
Conclusion: Proximal radioulnar derotational osteotomy followed by plate fixation is a safe and feasible procedure with a low complication rate. The technique can effectively improve the function of the forearm.