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]
Waters History and Clinical Presentation An otherwise healthy 19-month-old girl presented because her parents noticed that she was unable to eat with her left hand, and had difficulties with her right. [musculoskeletalkey.com]
when the patient presents with a lack of pronation and supination as seen in this case. [wajradiology.org]
Treatment
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]
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]
Treatment Each patient should be individually evaluated to determine the treatment required. Surgical treatment may be considered on the severity of the deformity and if the condition is bilateral. [boneandspine.com]
Prognosis
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]
Prognosis of Congenital Radioulnar Synostosis Overall, surgical treatment has high failure rates. [boneandspine.com]
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]
Introduction Define/describe the condition Anatomy Describe the pertinent anatomy Pathogenesis Describe the biomechanics/biologic basis of the disorder or the mechanism of injury Natural History Describe the natural history, epidemiology and prognosis [orthopaedicsone.com]
Etiology
Etiology unknown Genetics not specified 1/3 associated with other skeletal dysplasias Incidence unknown Associated Conditions radioulnar synostosis, ulnar dysplasia, nail-patella syndrome Clinical Evaluation: History / Exam Findings child is usually presents [posna.org]
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]
They help to detect underlying etiology such as callus formation after trauma. [pulsus.com]
Epidemiology
[…] 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]
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]
[…] proximal radius and ulna Etiology forearm begins as a single cartilaginous anlage and divides from distal to proximal into the radius and ulna in the 7th week in utero failure of differentiation results in synostosis in proximal aspect of the forearm Epidemiology [orthobullets.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]
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]
Careful dissection with minimal periosteal disruption prevents the further stimulation of bone, limiting recurrence. [emedicine.medscape.com]