Derotational osteotomy at the shafts of the radius and ulna for congenital radioulnar synostosis.

PURPOSE: The purpose of this study was to describe the results of a newly developed method of correction osteotomy for congenital radioulnar synostosis. With this method the osteotomy is performed at the distal one third of the radius and proximal one third of the ulna. After K-wires are inserted intramedullarly into both bones the forearm is derotated manually to the position planned before surgery followed by cast immobilization.

METHODS: Four patients with an average age of 3.9 years underwent surgery with this method and were followed-up for 45.8 months. All of their forearms were fixed before surgery at over 70 degrees of pronation.

RESULTS: The average correction after surgery was 65 degrees and bone union occurred at 8 weeks after surgery without any complications. The patients' ability to perform daily activities showed a marked improvement after surgery, but there was a 20 degrees loss of correction during cast immobilization in one case.

CONCLUSION: This method is a simple and safe technique to derotate the forearms of the patients with congenital radioulnar synostosis that are fixed in pronation.