Presentation
Congenital radioulnar synostosis (CRUS) causes a spectrum of presentations, most commonly a restriction of forearm rotation. [ncbi.nlm.nih.gov]
BACKGROUND: Congenital radioulnar synostosis (CRUS) causes a spectrum of presentations, most commonly a restriction of forearm rotation. [experts.umn.edu]
Immune System
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Splenomegaly
The chest was clear with normal bilateral equal air entry; however, abdominal examination revealed soft abdomen with no tenderness, with mild splenomegaly about 2 cm below the left costal margin, which was dull on percussion. [jahjournal.org]
Entire Body System
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Arm Pain
Keywords: Congenital malformation; Radioulnar synostosis; Derotational osteotomy Case Presentation A 21-month old Asian male was referred to an orthopedic surgeon by his pediatrician for left arm pain. [austinpublishinggroup.com]
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Crying
The father stated that when trying to gently assist in these movements, the patient would cry. The pediatrician referred the toddler after a limited range of motion exam and abnormal radiographic imaging. [austinpublishinggroup.com]
Liver, Gall & Pancreas
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Jaundice
On examination, the patient was looking sick, lethargic, jaundiced, and pale with tiny, cervical lymph nodes, of which the largest measured 1.2 cm in diameter. The consistency of the lymph nodes was rubbery, and they were not tender. [jahjournal.org]
Musculoskeletal
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Long Arm
Following surgery, the palm was immobilized in a fully supinated position by a long-arm cast. [ncbi.nlm.nih.gov]
A long arm cast with 90º of elbow flexion is utilized postoperatively for 8 weeks. Transcutaneous pins are recommended for fixation after derotation. [emedicine.medscape.com]
Neurologic
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Tantrums
Two-year-old Skylar’s sister wouldn’t share the body lotion she had, sending Skylar into a temper tantrum. [chop.edu]
Urogenital
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Cesarean Section
Her mother’s pregnancy was remarkable only for a cesarean section delivery 6 weeks preterm. She was noticed at birth to have bilateral inguinal hernias, both of which had since been repaired. [musculoskeletalkey.com]
The child is the first of a 29-year-old housewife delivered through an emergency cesarean section at term. The pregnancy was uneventful. There was no history of birth asphyxia or birth trauma. [wajradiology.org]
Treatment
This procedure is simple and safe in the treatment of congenital radioulnar synostosis. [ncbi.nlm.nih.gov]
Attitudes toward surgical treatment of the disease is very diverse, ranging from complete negation to acceptance. When choosing a treatment method, high recurrence and complication rates should be taken into account. Aims. [doaj.org]
1 A MECOM variant in an African American child with radioulnar synostosis and thrombocytopenia. ( 29200407 ) 2018 2 The reverse SauvAc-Kapandji procedure for the treatment of (posttraumatic) proximal radioulnar synostosis. ( 29520493 ) JimAcnez I....Delgado [malacards.org]
Classification / Treatment Treatment generally not indicated (Cleary JE, JBJS 1985;67Am:539). treatment not necessary if mild unilateral or no major functional loss. if bilateral and severe pronation—extensive release of synostosis, interosseous membrane [eorif.com]
Prognosis
Prognosis of Congenital Radioulnar Synostosis Overall, surgical treatment has high failure rates. [boneandspine.com]
Conservative observation Surgical early presentation (infancy) radial head reduction must have only mild deformity of radial head and capitellum technique: osteotomy of radius annular ligament reconstruction late presentation radial head excision Outcomes: Prognosis [posna.org]
Posttraumatic radioulnar synostosis is a separate entity from the congenital form, having a different cause, treatment, and prognosis. [3] The traumatic form can occur anywhere between the radius and ulna along the length of the interosseous membrane. [emedicine.medscape.com]
Your child’s long-term outlook depends on the severity of her deformity, as well as the prognosis for any associated conditions she may have. [brookiieleetylahh.wordpress.com]
Etiology
Each chapter has a case presentation, series of clinical questions, and fundamentals on etiology and epidemiology, clinical evaluation, and surgical indications. [books.google.de]
For severe deformity, recent consensus favors surgical management. 2,7–10 Pathophysiology Exact etiology is not known Chromosomal or other genetic abnormalities such as Klinefelter syndrome, XXXY syndrome, Apert syndrome, Crouzon syndrome, Carpenter syndrome [handsurgeryresource.com]
[…] synonyms: Congenital Radioulnar Synosto sis ICD-10 Q74.0: Other congenital malformations of upper limb(s), including shoulder girdle Congenital Radioulnar Synostosi s ICD-9 755.53 Radioulnar synostosis Congenital Radioulnar Synostosis Etiology / Epidemiology [eorif.com]
Other etiologies for the clinical finding of a stiff pronated forearm in children include: PEARLS Using biplanar radiographs, be sure that the smooth longitudinal pin is heading down the intramedullary canal of the ulna. [musculoskeletalkey.com]
Epidemiology
Each chapter has a case presentation, series of clinical questions, and fundamentals on etiology and epidemiology, clinical evaluation, and surgical indications. [books.google.de]
[…] synonyms: Congenital Radioulnar Synosto sis ICD-10 Q74.0: Other congenital malformations of upper limb(s), including shoulder girdle Congenital Radioulnar Synostosi s ICD-9 755.53 Radioulnar synostosis Congenital Radioulnar Synostosis Etiology / Epidemiology [eorif.com]
[…] separation of the distal radius and ulna for a time the proximal radius and ulna are united and share a common perichondrium abnormal genetic or teratogenic factors operating at this time would interfere with proximal radioulnar joint morphogenesis Epidemiology [gait.aidi.udel.edu]
Post-traumatic radioulnar synostosis Epidemiology This is much more common Rate between 2-6% (the latter figure in a series which used a single incision approach to the forearm). [nsec.com.au]
Pathophysiology
For severe deformity, recent consensus favors surgical management. 2,7–10 Pathophysiology Exact etiology is not known Chromosomal or other genetic abnormalities such as Klinefelter syndrome, XXXY syndrome, Apert syndrome, Crouzon syndrome, Carpenter syndrome [handsurgeryresource.com]
Groves later postulated that the success of treatment depended on where in the forearm synostosis had occurred. [4, 5] Pathophysiology The skeletal anomaly includes varying degrees of proximal radial and ulnar fusion, with or without involvement of the [emedicine.medscape.com]
Prevention
[…] of postoperative radioulnar synostosis after distal biceps repair. ( 28104092 ) 2017 10 Circumferential Adipofascial Graft for Prevention of Recurrence of Posttraumatic Radioulnar Synostosis. ( 29107381 ) 2017 11 The Dorsoulnar Artery Perforator Adipofascial [malacards.org]
Awareness of this crevice prevents accidental penetration into the soft tissues surrounding the proximal forearm. Fluoroscopic assistance prevents accidental penetration of the elbow joint. [musculoskeletalkey.com]
These involve excision of synostosis and interposition of inert tissue to prevent reformation of synostosis, However, synostosis typically recurs inspite of the interposition of silicone, fat, or muscle. [boneandspine.com]
The operative procedure included separation of the synostosis and placement of a free vascularized fascio-fat graft to prevent recurrent ankylosis. [insights.ovid.com]
Turning to experts to confirm the diagnosis Congenital radioulnar synostosis is a rare condition in which the forearm bones (radius and ulna) are fused together at the elbow, preventing a child from rotating their palm up or down. [chop.edu]