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Optimal management of post-traumatic radioulnar synostosis

Authors Osterman AL, Arief MS

Received 14 December 2016

Accepted for publication 4 May 2017

Published 5 December 2017 Volume 2017:9 Pages 101—106


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Clark Hung

A Lee Osterman,1 Melissa S Arief2

1Department of Orthopaedic & Hand Surgery, Philadelphia Hand to Shoulder Center, Thomas Jefferson University, Philadelphia, PA, 2KSF Orthopaedic Center, Houston, TX, USA

Abstract: Post-traumatic radioulnar synostosis is a rare complication after forearm or elbow injury that can result in loss of motion and significant disability. Risk factors include aspects of the initial trauma and of the surgical treatment of that trauma. Surgical intervention for synostosis is the standard of care and is determined based on the location of the bony bridge. Surgical timing is recommended between 6 months and 2 years with recent advocacy for the 6- to 12-month period after radiographs demonstrate bony maturation but early enough to prevent further stiffness and contractures. For most types of synostosis, surgical resection with interposition graft is recommended. The types of materials used include synthetic, allograft, and vascularized and non-vascularized materials, but currently there is no consensus on which is the most preferable. Adjuvant therapy is not considered necessary for all cases but can be beneficial in patients with high risk factors such as recurrence or traumatic brain injury. Postoperative rehabilitation should be performed early to maintain range of motion.

Keywords: radioulnar synostosis, forearm fracture, rotatory forearm motion, heterotopic bone forearm

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