SURGERY IN CONGENITAL RADIO ULNAR SYNOSTO SIS - TECHNICAL ERROR AND THERAPEUTIC STRATEGY

Purpose of the study A clinical feature of surgery in congenital radio ulnar synostosis is described. Material and methods A eigtheen year ol d right handed woman, was hampered when she works by a left congenital radio ulnar synostosis. Clinical examination showed a left forearm lo cked in 75 degrees of pronation. Radiographs showed a proximal synosto sis. Surgical treatment associated a resection of the synostosis with silastic interposition, resection of the distal end of the ulna, and d erotational middle-third osteotomy of the radius. Results Three months later, the pronosupination was 90 degrees, but an ischemic retraction of the flexor pollicis longus muscle appeared with a non-union of the radius. A second procedure was necessary to put a plate in compressio n on bone and to release the muscle. Twenty years later, the forearm w as locked in neutral pronosupination, without recurrence of synostosis on radiographs. Discussion Surgical treatment in congenital radio uln ar synostosis associates many problems : indication (often for discomf ort), ideal age (more vascular or nervous post operative complications if older), technical (failure of operations with functional aim). Con clusion A review of international litterature allows the authors to su ggest a specific management for congenital radio ulnar synostosis.