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Congenital Radioulnar Synostosis

Radioulnar Fusion


Presentation

  • Congenital radioulnar synostosis (CRUS) causes a spectrum of presentations, most commonly a restriction of forearm rotation.[ncbi.nlm.nih.gov]
  • Two patients with congenital radioulnar synostosis presented with painful snapping on elbow motion in one case and locking of the elbow joint in the other. Elbow arthroscopy revealed the presence of tight fibrous tissue trapping the radial head.[ncbi.nlm.nih.gov]
  • The technique presented here uses a small external fixation device that allows precise rotational correction and affords adequate stabilization yet avoids cast immobilization.[ncbi.nlm.nih.gov]
  • This report presents a 3-day-old infant with micrognathia, U-shaped cleft palate, low-set right ear with microtia, glossoptosis, esophageal atresia, and right congenital radioulnar synostosis.[ncbi.nlm.nih.gov]
  • The purpose of this paper is to present a patient with CRS who is currently functioning as a generator mechanic in the U.S. Army and to review the literature for current treatment options. We know of no other individual in the U.S.[ncbi.nlm.nih.gov]
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]
Developmental Disabilities
  • Possibility of developmental disability in congenitally infected children; Need for early intervention services; Program staff's concern over including infected children and their families in group programs and activities;...[connection.ebscohost.com]
Limited Mobility
  • I use language like, “I have limited mobility in this part of my body, so I will be modifying certain moves, but do you have any suggestions?” Being assertive in the fitness space makes me feel empowered and less insecure about my abilities.[self.com]
Pediatric Disorder
  • Pediatric Hand and Upper Limb Surgery guides you to the present indications for intervention and care in upper limb pediatric disorders.[books.google.de]
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]
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]
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]
Long Arm
  • Hyperpronation deformity due to congenital radioulnar synostosis has previously been managed by derotational osteotomy through the synostosis, while stabilization has been achieved with K-wires and a long arm cast.[ncbi.nlm.nih.gov]
  • Following surgery, the palm was immobilized in a fully supinated position by a long-arm cast.[ncbi.nlm.nih.gov]
  • A long-arm cast was applied for 4 to 6 weeks. Complications of surgeries were recorded, and pre- and postoperative forearm position was measured. RESULTS: The average postoperative follow-up was 5 years.[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]
Fear
  • I Rarely Run More Than 3 Miles at a Time—But I Still Deserve to Call Myself a Runner 6 Tips for Pushing Fear Aside So You Can Finally Reach Your Fitness Goals[self.com]
Fussiness
  • Review of systems was negative for: fevers, abnormal weight change, changes in appetite, changes in sleep patterns, changes in behavior, excessive fussiness, vomiting, diarrhea, other joint pains or signs of inflammation.[austinpublishinggroup.com]
Tantrums
  • Two-year-old Skylar’s sister wouldn’t share the body lotion she had, sending Skylar into a temper tantrum.[chop.edu]
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

  • 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]
  • Army and to review the literature for current treatment options. We know of no other individual in the U.S. Army who is on active duty status with this deformity.[ncbi.nlm.nih.gov]
  • Final treatment consisted of reassurance and active ROM exercises, with resolution of symptoms.[ncbi.nlm.nih.gov]
  • This procedure is simple and safe in the treatment of congenital radioulnar synostosis.[ncbi.nlm.nih.gov]
  • The present study evaluates the result of two-stage double-level rotational osteotomy of both the radius and ulna in the treatment of severe congenital radioulnar synostosis.[ncbi.nlm.nih.gov]

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]
  • This entity can be distinguished from the TAR syndrome (thrombocytopenia and absent radii) by the distinctive orthopedic issues, different underlying genetic mutations, and a more worrisome prognosis for CAMT than for TAR.[nature.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]
Sex distribution
Age distribution

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]

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