TY - JOUR
T1 - Proximal radial resection for posttraumatic radioulnar synostosis
T2 - A new technique to improve forearm rotation
AU - Kamineni, Srinath
AU - Maritz, N. G.
AU - Morrey, Bernard F.
PY - 2002/5
Y1 - 2002/5
N2 - Background: Heterotopic ossification about the elbow joint can lead to considerable functional disability, including the loss of forearm rotation. Many procedures have been described for the treatment of proximal radioulnar synostosis. Varying degrees of success have been achieved with regard to the improvement of the flexion arc, but less success has been reported in terms of the restoration of forearm rotation. The success of treatment is associated with the extent of heterotopic ossification, soft-tissue scarring, and anatomical distortion. A new and simple technique to address the unresectable proximal radioulnar synostosis is described. Methods: Seven patients were managed with a partial proximal radial resection distal to the synostosis and were followed for an average of eighty months (range, twenty-four to 144 months). Results: Forearm rotation improved from an average fixed pronation of 5° to an average arc of 98° (range, 40° to 175°). The average functional score improved from 57 points preoperatively to 81 points at the time of the final review. Complications included reankylosis at the site of the resection and ulnar-nerve sensory neurapraxia in one patient each. Conclusions: Resection of a 1-cm-thick section of the proximal part of the radial shaft provides a safe and reliable method of improving forearm rotation in patients with heterotopic ossification of the elbow. A single technical factor that seems to positively influence the result is the application of bone wax at the resection site. This simple procedure is ideally suited for patients who have a proximal radioulnar synostosis that (1) is too extensive to allow a safe and discrete resection, (2) involves the articular surface, and (3) is associated with an anatomical deformity.
AB - Background: Heterotopic ossification about the elbow joint can lead to considerable functional disability, including the loss of forearm rotation. Many procedures have been described for the treatment of proximal radioulnar synostosis. Varying degrees of success have been achieved with regard to the improvement of the flexion arc, but less success has been reported in terms of the restoration of forearm rotation. The success of treatment is associated with the extent of heterotopic ossification, soft-tissue scarring, and anatomical distortion. A new and simple technique to address the unresectable proximal radioulnar synostosis is described. Methods: Seven patients were managed with a partial proximal radial resection distal to the synostosis and were followed for an average of eighty months (range, twenty-four to 144 months). Results: Forearm rotation improved from an average fixed pronation of 5° to an average arc of 98° (range, 40° to 175°). The average functional score improved from 57 points preoperatively to 81 points at the time of the final review. Complications included reankylosis at the site of the resection and ulnar-nerve sensory neurapraxia in one patient each. Conclusions: Resection of a 1-cm-thick section of the proximal part of the radial shaft provides a safe and reliable method of improving forearm rotation in patients with heterotopic ossification of the elbow. A single technical factor that seems to positively influence the result is the application of bone wax at the resection site. This simple procedure is ideally suited for patients who have a proximal radioulnar synostosis that (1) is too extensive to allow a safe and discrete resection, (2) involves the articular surface, and (3) is associated with an anatomical deformity.
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U2 - 10.2106/00004623-200205000-00007
DO - 10.2106/00004623-200205000-00007
M3 - Article
C2 - 12004015
AN - SCOPUS:0036562938
VL - 84
SP - 745
EP - 751
JO - Journal of Bone and Joint Surgery - American Volume
JF - Journal of Bone and Joint Surgery - American Volume
SN - 0021-9355
IS - 5
ER -