Congenital Proximal Radioulnar Synostosis - Excision of Synostosis mass with Interposition of Distally based Pedicled Fat Graft

Abstract

Congenital radioulnar synostosis is a rare            congenital anamoly involving radius and ulna, most               commonly the proximal ends. The movements between          radius and ulna are restricted and the forearm is fixed.It is mostly bilateral with familial predisposition. There are two groups of surgical procedures described for treating this  condition.One group comprises surgical procedures which are aimed at mobility of the forearm and other group includes procedure with an aim to improve the fixed position of forearm rotation to a functional one. We present two cases for which excision of Synostosis mass with Interposition of Distally based Pedicled Fat Graft done. It provides forearm rotation ranging from 50 to 80 degrees.In one of our cases this             procedure restores 20 of supination to 60 degrees of              pronation from preoperative fixed 10 degrees of supination of forearm.We found that use of a pedicled fat graft as an            interpositional material provides useful range of rotation of forearm in cases where the position of fixed rotation is          minimal(less than 20 degrees).