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Surgical outcome of delayed presentation of congenital proximal radioulnar synostosis

Background: Presentation of proximal radioulnar synostosis varies from cosmetic concerns with no functional limitations to significant pronation deformity which hampers activities of daily living. Surgical management must be considered based on the position of the forearm and functional limitations....

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Autores principales: Garg, Gaurav, Gupta, Som P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDP Sciences 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849273/
https://www.ncbi.nlm.nih.gov/pubmed/27163088
http://dx.doi.org/10.1051/sicotj/2015035
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author Garg, Gaurav
Gupta, Som P.
author_facet Garg, Gaurav
Gupta, Som P.
author_sort Garg, Gaurav
collection PubMed
description Background: Presentation of proximal radioulnar synostosis varies from cosmetic concerns with no functional limitations to significant pronation deformity which hampers activities of daily living. Surgical management must be considered based on the position of the forearm and functional limitations. We describe the surgical technique, results, and complications of excision of the radial head along with the proximal radius up to the distal extent of the synostosis site and securing the osteotomized radial shaft with a tensor fascia lata graft. Materials and methods: Four patients having six affected elbows with delayed presentation of congenital proximal radioulnar synostosis with dislocated radial head managed surgically were included in the study. There were three males and one female with an average age of 20.25 years (ranging from 16 to 25 years). Preoperatively wrists were locked in the mean pronation position of 51.6° (ranging from 30° to 70°). The indications for surgery were limitation in activities of daily living and an obvious cosmetic deformity. Results: All patients were satisfied with the surgery and showed significant improvement in functional status. Mean active supination was 15° (ranging from 5 to 32°) with passive supination was a mean of 24.8° (ranging from 11° to 44°). Similarly, mean active pronation was 58.5° (ranging from 50° to 71°) with further passive correction up to a mean of 64.16° (ranging from 57° to 87°) at last follow up. Conclusions: This procedure is simple, cost effective, and a reasonable option for treatment of proximal radioulnar synostosis with a dislocated radial head in adult patients. The operation does not require any specialized team or implants, and can be performed in a moderately equipped hospital.
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spelling pubmed-48492732016-05-09 Surgical outcome of delayed presentation of congenital proximal radioulnar synostosis Garg, Gaurav Gupta, Som P. SICOT J Original Article Background: Presentation of proximal radioulnar synostosis varies from cosmetic concerns with no functional limitations to significant pronation deformity which hampers activities of daily living. Surgical management must be considered based on the position of the forearm and functional limitations. We describe the surgical technique, results, and complications of excision of the radial head along with the proximal radius up to the distal extent of the synostosis site and securing the osteotomized radial shaft with a tensor fascia lata graft. Materials and methods: Four patients having six affected elbows with delayed presentation of congenital proximal radioulnar synostosis with dislocated radial head managed surgically were included in the study. There were three males and one female with an average age of 20.25 years (ranging from 16 to 25 years). Preoperatively wrists were locked in the mean pronation position of 51.6° (ranging from 30° to 70°). The indications for surgery were limitation in activities of daily living and an obvious cosmetic deformity. Results: All patients were satisfied with the surgery and showed significant improvement in functional status. Mean active supination was 15° (ranging from 5 to 32°) with passive supination was a mean of 24.8° (ranging from 11° to 44°). Similarly, mean active pronation was 58.5° (ranging from 50° to 71°) with further passive correction up to a mean of 64.16° (ranging from 57° to 87°) at last follow up. Conclusions: This procedure is simple, cost effective, and a reasonable option for treatment of proximal radioulnar synostosis with a dislocated radial head in adult patients. The operation does not require any specialized team or implants, and can be performed in a moderately equipped hospital. EDP Sciences 2015-12-11 /pmc/articles/PMC4849273/ /pubmed/27163088 http://dx.doi.org/10.1051/sicotj/2015035 Text en © The Authors, published by EDP Sciences, 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Garg, Gaurav
Gupta, Som P.
Surgical outcome of delayed presentation of congenital proximal radioulnar synostosis
title Surgical outcome of delayed presentation of congenital proximal radioulnar synostosis
title_full Surgical outcome of delayed presentation of congenital proximal radioulnar synostosis
title_fullStr Surgical outcome of delayed presentation of congenital proximal radioulnar synostosis
title_full_unstemmed Surgical outcome of delayed presentation of congenital proximal radioulnar synostosis
title_short Surgical outcome of delayed presentation of congenital proximal radioulnar synostosis
title_sort surgical outcome of delayed presentation of congenital proximal radioulnar synostosis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849273/
https://www.ncbi.nlm.nih.gov/pubmed/27163088
http://dx.doi.org/10.1051/sicotj/2015035
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