Zarantonello Paola, Trisolino Giovanni, Senes Filippo Maria, Di Gennaro Giovanni Luigi, Antonioli Diego, Catena Nunzio, Culmone Annalisa, Stauffer Alexandra, Chiarella Laetitia Sophie, Farr Sebastian
Department of Argenta, IRCCS-Istituto Ortopedico Rizzoli, Bologna, Italy.
Department of Pediatrics Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
J Child Orthop. 2025 Jun 9:18632521251322677. doi: 10.1177/18632521251322677.
Congenital radioulnar synostosis is a congenital disorder affecting the elbow. We aimed to investigate the baseline characteristics and the clinical and functional outcome of a cohort of children with congenital radioulnar synostosis undergoing operative and non-operative treatment.
This multicenter retrospective study evaluated children with congenital radioulnar synostosis admitted to three European pediatric orthopedic centers from January 1998 to April 2021. Baseline characteristics were extracted from medical records. Operative cases treated with rotational osteotomy were further analyzed. Outcomes were assessed using the Mayo Elbow Performance Score and the Quick-DASH questionnaire.
Ninety-seven patients (122 forearms) were included. Forearm positions were predominantly neutral or excessively pronated. Type 3 Congenital radioulnar synostosis was the most common radiographic finding. A total of 52 patients (66 forearms) underwent proximal derotational osteotomy, achieving a neutral forearm position in 61.9% of cases. Six complications were reported. The mean follow-up was 4.5 ± 3.4 years. MEPS averaged 90.6 points and Quick-DASH 18.5 points. No significant differences were found between operated and non-operated cases. MEPS results were good or excellent in 77.9% of patients, while only 31% reported a Quick-DASH ≤ 7points.
We present the largest case series of pediatric congenital radioulnar synostosis to date. Mild deformities caused minimal disability and required no surgery. For severe malrotation, proximal derotational osteotomy was safe, with low complication rates, restoring a neutral forearm position and yielding outcomes comparable to non-surgical management of mild cases.
先天性桡尺骨融合是一种影响肘部的先天性疾病。我们旨在研究一组接受手术和非手术治疗的先天性桡尺骨融合患儿的基线特征、临床及功能结局。
这项多中心回顾性研究评估了1998年1月至2021年4月间入住欧洲三个儿科骨科中心的先天性桡尺骨融合患儿。从病历中提取基线特征。对接受旋转截骨术治疗的手术病例进行进一步分析。使用梅奥肘关节功能评分和Quick-DASH问卷评估结局。
纳入97例患者（122条前臂）。前臂位置主要为中立位或旋前过度。3型先天性桡尺骨融合是最常见的影像学表现。共有52例患者（66条前臂）接受了近端去旋转截骨术，61.9%的病例前臂达到中立位。报告了6例并发症。平均随访时间为4.5±3.4年。梅奥肘关节功能评分平均为90.6分，Quick-DASH评分为18.5分。手术和非手术病例之间未发现显著差异。77.9%的患者梅奥肘关节功能评分结果为良好或优秀，而只有31%的患者报告Quick-DASH≤7分。
我们展示了迄今为止最大的小儿先天性桡尺骨融合病例系列。轻度畸形导致的残疾最小，无需手术。对于严重旋转不良，近端去旋转截骨术是安全的，并发症发生率低，可恢复前臂中立位，其结局与轻度病例的非手术治疗相当。
