Radioulnar synostosis

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Classification according to ICD-10
Q74.0 Other congenital malformations of the upper extremity (s) and shoulder girdle

Including: Accessory carpal bones Congenital pseudoarthrosis of the clavicle Dysostosis cleidocranialis Madelung deformity Macrodactyly (finger) Sprengel deformity Synostosis radioulnaris Triphalangia of the thumb

ICD-10 online (WHO version 2019)

A radioulnar synostosis ( Latin synostosis radioulnaris ) means a bony connection between the radius (radius) and ulna (ulna) just below the elbow joint. A turning movement is not possible.

Congenital radioulnar synostosis in a 7 year old child

etiology

After injuries to the radial head, the acquired post-traumatic form of synostosis often occurs . Details on this acquired shape can be found under fracture of the radial head .

The congenital ( congenital ) form is to be distinguished, in which the radial head is usually missing, in 60% the change occurs on both sides. The forearm is fixed in a pronation position. The cause of the embryonic segmentation disorder is unknown; 25% are hereditary.

clinic

The lack of mobility in the congenital form is already noticeable after birth. There are no complaints. Depending on the fixed position, there may be functional restrictions, e.g. B. come with writing and hygiene. The restricted rotation can be largely compensated by increasing shoulder and elbow movement.

The change can be found associated with:

Diagnosis

An X-ray confirms the diagnosis on the basis of the typical deviation of the proximal radius, the indistinguishable radial head and evidence of synostosis. The congenital radial head dislocation is to be distinguished.

Differential diagnosis

The elbow aplasia , a humeroradioulnar synostosis, is to be distinguished.

treatment

A causal therapy is not possible: an operative separation has so far not been successful. A surgical procedure in the sense of a derotation osteotomy is useful if the pronation is too pronounced . Writing hand in slight pronation, opposite hand in neutral position or slight supination The operation should be performed between the ages of 8 and 10 years in the middle of the forearm.

Individual evidence

  1. ↑ a b c F. Hefti: Pediatric orthopedics in practice . Springer 1998, ISBN 3-540-61480-X .
  2. ↑ a b c J. E. Cleary, GE Omer: Congenital proximal radio-ulnar synostosis. Natural history and functional assessment. In: The Journal of bone and joint surgery. American volume. Volume 67, Number 4, April 1985, pp. 539-545, ISSN  0021-9355 . PMID 3980498 .
  3. ↑ K. Yammine, A. Salon, JC Pouliquen: Congenital radioulnar synostosis. Study of a series of 37 children and adolescents. In: Chirurgie de la main. Volume 17, Number 4, 1998, pp. 300-308, ISSN  1297-3203 . PMID 10855298 .
  4. ^ Lexicon orthopedics
  5. ^ B. Leiber: The clinical syndromes. Syndromes, sequences and symptom complexes. Edited by G. Burg, J. Kunze, D. Pongratz, PG Scheurlen, A. Schinzel, J. Spranger, 7th edition. Urban & Schwarzenberg, 1990, ISBN 3-541-01727-9 .

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