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Minimally invasive single-session double-level rotational osteotomy of the forearm bones to correct fixed pronation deformity in congenital proximal radioulnar synostosis.

Bishay SN - J Child Orthop (2016)

Bottom Line: They were evaluated for functional results after rotational corrective osteotomy at a mean interval of 30.4 months (range 24-36 months) by physical examination and radiographs.All children showed improvement in functional activities, with no loss of correction or non-union in any child, and no circulatory disturbances, neuropathies, or hypertrophic scars.Minimally invasive single-session double-level rotation osteotomy of the proximal ulna and distal radius with percutaneous intramedullary K-wire fixation is a safe, technically simple and efficient procedure which corrects pronation deformity.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, National Institute of Neuromotor System, 51 Al-Madina Al-Menawara Street, Al-Mouhandeseen, Imbaba, Giza, 12411, Egypt. sherifbishay@outlook.com.

ABSTRACT

Background: Congenital proximal radioulnar synostosis is the most common congenital disease of the elbow joints and forearms.

Methods: This was a prospective study of 12 consecutive children (14 forearms) who presented to the National Institute of Neuromotor System in Egypt between September 2012 and September 2013 with severe congenital proximal radioulnar synostosis, having a mean pronation deformity of 70.7° (range 60°-85°), and who underwent operative correction by single-session double-level rotational osteotomy and percutaneous intramedullary K-wires of both the radius and ulna. Ten forearms were type III, and four were type II according to Cleary and Omer classification. The mean age at the time of surgery was 5 years and 2 months (range 4 years and 10 months to 6 years and 5 months). They were evaluated for functional results after rotational corrective osteotomy at a mean interval of 30.4 months (range 24-36 months) by physical examination and radiographs.

Results: All children had a mean pronation deformity correction of 59.8° (range 30°-90°) reaching a final position of 20°-30° of pronation in the affected dominant extremities and 20° of supination in the affected non-dominant extremities after osteotomy. All children showed improvement in functional activities, with no loss of correction or non-union in any child, and no circulatory disturbances, neuropathies, or hypertrophic scars.

Conclusion: Minimally invasive single-session double-level rotation osteotomy of the proximal ulna and distal radius with percutaneous intramedullary K-wire fixation is a safe, technically simple and efficient procedure which corrects pronation deformity.

No MeSH data available.


Related in: MedlinePlus

Postperative (8 weeks) anteroposterior (left) and lateral (right) views showing the rotation and union
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Fig4: Postperative (8 weeks) anteroposterior (left) and lateral (right) views showing the rotation and union

Mentions: The mean duration of follow-up was 30.4 months (range 24–36 months). Bone union was achieved in all patients, with a mean duration of 6.9 weeks (range 6–8 weeks). The mean time for complete removal of the cast was 6.5 weeks (range 6–8 weeks). The mean correction achieved after surgery was 59.8° (range 30°–90°) with a final position of 20°–30° of pronation in the affected dominant extremities and 20° of supination in the affected non-dominant extremities (Table 2). Elbow movements (extension and flexion) and wrist movements (dorsiflexion, palmarflexion, adduction, and abduction) were unaffected by the operation. At follow-up, there was no loss of correction (Fig. 3) or radiographic non-union (Fig. 4) in any child, and no circulatory disturbances, neuropathies, or hypertrophic scars on the forearm. All children showed marked functional improvement compared with the preoperative state, particularly in their daily activities such as eating, washing, dressing and accepting objects in the palm of the hand. All children and their families were satisfied with the results.Table 2


Minimally invasive single-session double-level rotational osteotomy of the forearm bones to correct fixed pronation deformity in congenital proximal radioulnar synostosis.

Bishay SN - J Child Orthop (2016)

Postperative (8 weeks) anteroposterior (left) and lateral (right) views showing the rotation and union
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940245&req=5

Fig4: Postperative (8 weeks) anteroposterior (left) and lateral (right) views showing the rotation and union
Mentions: The mean duration of follow-up was 30.4 months (range 24–36 months). Bone union was achieved in all patients, with a mean duration of 6.9 weeks (range 6–8 weeks). The mean time for complete removal of the cast was 6.5 weeks (range 6–8 weeks). The mean correction achieved after surgery was 59.8° (range 30°–90°) with a final position of 20°–30° of pronation in the affected dominant extremities and 20° of supination in the affected non-dominant extremities (Table 2). Elbow movements (extension and flexion) and wrist movements (dorsiflexion, palmarflexion, adduction, and abduction) were unaffected by the operation. At follow-up, there was no loss of correction (Fig. 3) or radiographic non-union (Fig. 4) in any child, and no circulatory disturbances, neuropathies, or hypertrophic scars on the forearm. All children showed marked functional improvement compared with the preoperative state, particularly in their daily activities such as eating, washing, dressing and accepting objects in the palm of the hand. All children and their families were satisfied with the results.Table 2

Bottom Line: They were evaluated for functional results after rotational corrective osteotomy at a mean interval of 30.4 months (range 24-36 months) by physical examination and radiographs.All children showed improvement in functional activities, with no loss of correction or non-union in any child, and no circulatory disturbances, neuropathies, or hypertrophic scars.Minimally invasive single-session double-level rotation osteotomy of the proximal ulna and distal radius with percutaneous intramedullary K-wire fixation is a safe, technically simple and efficient procedure which corrects pronation deformity.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, National Institute of Neuromotor System, 51 Al-Madina Al-Menawara Street, Al-Mouhandeseen, Imbaba, Giza, 12411, Egypt. sherifbishay@outlook.com.

ABSTRACT

Background: Congenital proximal radioulnar synostosis is the most common congenital disease of the elbow joints and forearms.

Methods: This was a prospective study of 12 consecutive children (14 forearms) who presented to the National Institute of Neuromotor System in Egypt between September 2012 and September 2013 with severe congenital proximal radioulnar synostosis, having a mean pronation deformity of 70.7° (range 60°-85°), and who underwent operative correction by single-session double-level rotational osteotomy and percutaneous intramedullary K-wires of both the radius and ulna. Ten forearms were type III, and four were type II according to Cleary and Omer classification. The mean age at the time of surgery was 5 years and 2 months (range 4 years and 10 months to 6 years and 5 months). They were evaluated for functional results after rotational corrective osteotomy at a mean interval of 30.4 months (range 24-36 months) by physical examination and radiographs.

Results: All children had a mean pronation deformity correction of 59.8° (range 30°-90°) reaching a final position of 20°-30° of pronation in the affected dominant extremities and 20° of supination in the affected non-dominant extremities after osteotomy. All children showed improvement in functional activities, with no loss of correction or non-union in any child, and no circulatory disturbances, neuropathies, or hypertrophic scars.

Conclusion: Minimally invasive single-session double-level rotation osteotomy of the proximal ulna and distal radius with percutaneous intramedullary K-wire fixation is a safe, technically simple and efficient procedure which corrects pronation deformity.

No MeSH data available.


Related in: MedlinePlus