Mahajan Neetin P, Kumar Gsp, Yadav Amit Kumar, Mane Akash V, Gop Akhil
Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India.
J Orthop Case Rep. 2020 Oct;10(7):49-52. doi: 10.13107/jocr.2020.v10.i07.1914.
Radioulnar synostosis is a bony connection between the radius and ulna, which causes restriction of the active and passive rotational movements of the forearm such as supination and pronation, which can lead to significant functional disability in the patients.
A 35-year-old male carpenter presented with the complaint of right forearm supination and pronation restriction for the past 8 months with minimal pain at the elbow region with no previous history of trauma or surgery. On examination, forearm supination and pronation movements were completely restricted with normal elbow flexion and extension and with no neurovascular deficit. X-ray of the right radius ulna with elbow revealed synostosis between proximal radius and ulna at the level of the radial tuberosity. Synostosis was removed using both anterior and posterior approaches. Postoperatively patient is having good supination and pronation movements, no pain, and difficulty in his occupation.
Idiopathic proximal radioulnar synostosis should be suspected in patients having restricted rotatory movements of forearm with no previous history of trauma or surgery and this is the first reported case of idiopathic proximal radioulnar synostosis. Complete resection of the synostosis with early initiation of aggressive physiotherapy helps in getting good functional outcomes.
桡尺骨融合是桡骨和尺骨之间的骨性连接，会导致前臂主动和被动旋转运动受限，如旋后和旋前，这可能会给患者带来严重的功能残疾。
一名35岁男性木匠主诉右前臂旋后和旋前受限8个月，肘部区域疼痛轻微，既往无创伤或手术史。检查发现，前臂旋后和旋前运动完全受限，肘部屈伸正常，无神经血管缺损。右桡尺骨及肘部X线显示，在桡骨结节水平的桡骨近端和尺骨之间存在融合。采用前后联合入路切除融合。术后患者旋后和旋前运动良好，无疼痛，职业活动无困难。
对于无前驱创伤或手术史且前臂旋转运动受限的患者，应怀疑特发性近端桡尺骨融合，这是首例特发性近端桡尺骨融合的报告病例。彻底切除融合并早期积极开展物理治疗有助于获得良好的功能结果。
