Treatment of children’s proximal radioulnar joint fusion through single dual-plane osteotomy on combination with multi-sequence cast - a new method for treating the children’s proximal radioulnar joint fusion

Abstract

To introduce an improved method of de-rotation osteotomy for treating the congenital proximal radioulnar joint fusion: single dual-plane osteotomy combined with multi-sequence cast. Twelve child patients with congenital proximal radioulnar joint fusion (16 limbs) had been treated from 2014 to 2017 with single dual-plane osteotomy combined with multi-sequence cast method. 12 of 16 limbs were corrected in position after one-time cast change, and the remaining 4 limbs of two patients needed to receive cast change for two times before correction. Neither one suffered related nervous and vascular complications, nor one suffered ischemic contracture after all the cases received cast fixation, and it took 8 weeks for their osteotomy parts to reach bony union averagely after operation.The affected limb’s functional evaluation before operation was averagely 5.75 scores (4~8); 12 movements could be completed fully after operation, i.e., functional evaluation reached 12 scores. This surgical operation is easy to operate with good operation result and big range of correction. It can also effectively avoid the occurrence of angioneurotic complications after operation with a high safety. Therefore, it is an ideal alternative method to treat the congenital proximal radioulnar joint fusion in the present stage when joint fusion dissociation operation is not matured.

Keywords:
congenital; radioulnar synostosis; congenital proximal radioulnar synostosis; rotational osteotomy; osteotomy