Application of fusion site osteotomy combined with ulna and radius osteotomy for the treatment of congenital proximal radioulnar synostosis

Objective To explore the clinical features and surgical treatment of congenital proximal radioulnar synostosis. Methods From May 2014 to May 2017, 9 cases of congenital proximal radioulnar synostosis were treated in our hospital. By preoperative X-ray examination, forearm shape, forearm rotation function, elbow flexion and extension function, the fusion and development of radial head, ulna and radius were observed and classified. The operations including fusion site osteotomy, ulna osteotomy, radius osteotomy, interosseous membrane release and circular ligament reconstruction were performed. Results Nine patients performed operation on 14 sides were follow-up for 3 to 38 months with an average of 17 months. No re-synostosis occurred, and the shape and rotation function of the forearm were improved. The elbow function was evaluated by Mayo score, and the results were excellent in 7 sides, good in 5 sides and fair in 2 sides. Conclusion Congenital proximal radioulnar synostosis seriously affects the quality of life of children, and the fusion site osteotomy combined with ulna and radius osteotomy can achieve good treatment outcomes. Key words: Congenital abnormalities; Surgical procedures, operative; Proximal radioulnar synostosis; Osteotomy