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Children's Orthopaedics

CONGENITAL RADIOULNAR SYNOSTOSIS; A NEW OPERATIVE TECHNIQUE FOR OBTAINING FUNCTIONAL SUPINATION – PRONATION RANGE, A SERIES OF ELEVEN CASES

British Society for Children's Orthopaedic Surgery (BSCOS) and British Limb Reconstruction Society (BLRS)



Abstract

Background

CRUS is difficult to treat. Many techniques have been tried in an effort to restore forearm rotation; however, they have not been successful. It is inadvisable by many authors to perform any operation with the hope of obtaining pronation and supination.

Patients and Methods

Eleven children; 3 - 8 years old with CRUS, Wilkie type I, with fixed full pronation deformity were managed by the new ALLAM'S OPERATION which is a one stage intervention including separation of the bony fusion, special cementation technique of the ulnar (or radial) side of the osteotomy, double osteotomy of the radius and a single osteotomy of the ulna (all of the 3 osteotomies were done percutaneously) with intramedullary K. wire fixation of osteotomies at the mid-prone position and above elbow cast application for 6 weeks.

Results

Excellent significant functional range of forearm rotation was obtained with no significant complications after a follow-up period of 3 – 4 y. (average: 3.2 m).

Summary

The new ALLAM'S OPERATION is a one stage intervention for CRUS, (Wilkie type I, with fixed full pronation deformity) with significant obtained active functional range of forearm rotation with no significant complications after an average follow-up period of more than 3 years.