Single osteotomy at the radial diaphysis for congenital radioulnar synostosis.

PURPOSE: To report the effectiveness of single derotation osteotomy at the radial diaphysis for the treatment of congenital radioulnar (RU) synostosis.

METHODS: Since 2000, we performed 35 radial diaphysis osteotomies on 17 boys and 9 girls younger than 9 years old (average, 5 y). The radius was cut at the midshaft and manually rotated to a neutral position. A long-arm cast was applied for 4 to 6 weeks. Complications of surgeries were recorded, and pre- and postoperative forearm position was measured.

RESULTS: The average postoperative follow-up was 5 years. The patient age at the final follow-up ranged from 5 to 19 years. There were no major surgery-related complications. The average forearm position was improved from 72° pronation before surgery to neutral after surgery, except 2 forearms. Elbow flexion and extension showed no change. All parents noted that daily activities were improved after surgery, and they found the surgical scar in the midforearm acceptable.

CONCLUSIONS: Single osteotomy at the radial diaphysis was effective for correcting pronation deformity in congenital RU synostosis in children younger than 9 years. Complications were few, and the correction was maintained through midterm follow-up.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.