Presentation
Congenital radioulnar synostosis (CRUS) causes a spectrum of presentations, most commonly a restriction of forearm rotation. [ncbi.nlm.nih.gov]
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]
when the patient presents with a lack of pronation and supination as seen in this case. [wajradiology.org]
BACKGROUND: Congenital radioulnar synostosis (CRUS) causes a spectrum of presentations, most commonly a restriction of forearm rotation. [experts.umn.edu]
Entire Body System
- Anemia
Stay current on the developments and research surrounding neonatal anemia from the entirely new chapter on Blood and Hematopoietic System highlights. [books.google.de]
Thrombocytopenia Absent Radius Syndrome and Fanconi Anemia. Congenital radioulnar synostosis (RUS), a rare developmental anomaly involving fusion of the bones of the forearms, has been recognized in the orthopedic literature since the mid-1800s. [bloodjournal.org]
Examination of the blood film revealed microcytic, hypochromic anemia, thrombocytopenia, neutropenia, and thus, pancytopenia in addition to immature mononuclear cells with high nuclear–cytoplasmic ratio, open chromatin, and faint nucleoli. [jahjournal.org]
Chromosomal fragility testing was normal excluding Fanconi anemia. She died of a sudden overwhelming infection following stem cell transplantation. [nature.com]
- Ecchymosis
Skin exam was normal with no erythema, edema, or ecchymosis. There was no tenderness to palpation of the left or right elbow including the lateral epicondyle, forearm, and wrist. [austinpublishinggroup.com]
Musculoskeletal
- Fracture
Radiology Imaging Dislocated Ankle Ankle Fracture Ankle Surgery Rad Tech Bogota Colombia Medical Care Physiology Trauma Forward Unstable Weber B fracture of the right distal fibular and fracture of the medial malleolus (bimalleolar ankle fracture) with [pinterest.fr]
Risk factors Single incisions for both bone fractures High energy fractures Head injuries Monteggia fractures and more proximal fractures Surgical technique Leaving bone fragments behind Creation of communicating haematoma between radius and ulna Treatment [nsec.com.au]
The most common cause: operatively treated forearm fracture. Patients with high-energy, comminuted, open fractures. Monteggia and proximal forearm fractures. The use of bone graft and screws protruding through the opposite cortex. Any trauma [slideshare.net]
Long-term results after simple rotational osteotomy of the radius shaft for congenital radioulnar synostosis. ( 30016690 ) Satake H...Takagi M 2018 6 Posttraumatic Proximal Radioulnar Synostosis after Closed Reduction for a Radial Neck and Olecranon Fracture [malacards.org]
[…] of the humerus Monteggia fractures of the ulna Hypoplastic radial heads [handsurgeryresource.com]
Psychiatrical
- 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]
Treatment
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]
Congenital Proximal Radioulnar Synostosis: Treatment with the Ilizarov Method. [wheelessonline.com]
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]
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]
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]
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]
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]
Etiology
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]
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]
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]
They help to detect underlying etiology such as callus formation after trauma. [pulsus.com]
Epidemiology
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]
Each chapter has a case presentation, series of clinical questions, and fundamentals on etiology and epidemiology, clinical evaluation, and surgical indications. [books.google.de]
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]
[…] 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]
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
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]
Careful dissection with minimal periosteal disruption prevents the further stimulation of bone, limiting recurrence. [emedicine.medscape.com]
[…] 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]
The contracted soft tissues will also prevent any meaningful return of motion. Derotation and fixation in the derotated position is preferred. [nsec.com.au]
The operative procedure included separation of the synostosis and placement of a free vascularized fascio-fat graft to prevent recurrent ankylosis. [insights.ovid.com]