Traumatic elbow dislocation in a patient with congenital radioulnar synostosis

This case report describes a traumatic elbow dislocation in a patient with congenital radioulnar synostosis. It discusses the difficulties and potential complications of managing this complicated injury. Congenital radioulnar synostosis (CRUS) is a rare elbow pathology that is characterised by the abnormal fusion of the proximal radius and ulna bones at the elbow. This case report describes a traumatic posterior elbow dislocation in a 30 year old patient with CRUS. Patients with CRUS are more susceptible to elbow dislocation due to laxity of stabilising ligaments and increased stiffness of the forearm leading to greater force transfer to the elbow. CRUS should be considered in patients with difficult to reduce elbow dislocations.

Vascularized ulnar periosteal pedicled flap for forearm nonunion in children

We report our experience with the use of a vascularized ulnar periosteal pedicled flap to treat forearm nonunion in children. Seven children underwent surgical treatment of radial diaphysis nonunion with this technique. The mean duration of nonunion prior to the flap was 9 months. Significant postoperative improvements were observed in pain severity (mean visual analogue scale score of 0.6), Quick Disabilities of the Arm, Shoulder, and Hand (mean score of 7.1) and grip strength (89% higher than preoperative status). Union was achieved in all patients, with a mean time to union of 3 months. One patient developed distal radioulnar synostosis as a postoperative complication. A vascularized ulnar periosteal pedicled flap is a reliable and versatile technique for treating forearm nonunion in children, associated with both good outcomes and low donor morbidity. Level of evidence: IV

Poland’s syndrome concomitant with congenital proximal and distal radioulnar synostosis: A rare case report

Radioulnar synostosis is a rare disease which causes supination and pronation restriction as a result of osseous or fibrous connections between the radius and ulna. Radioulnar synostosis includes both congenital and post-traumatic types. Post-traumatic radioulnar synostosis can be seen in the proximal, middle, and distal part of the forearm, depending on the location of the trauma. Congenital proximal radioulnar synostosis occurs as a result of a separation defect between the radius and ulna in the embryonic period. In the presence of congenital proximal radioulnar synostosis, the patient should be evaluated for accompanying syndromes and possible developmental anomalies. In this report, we present a rare case of both proximal and distal radioulnar synostosis. Hypoplasia of the right pectoral muscle mass, hypoplastic appearance of the right nipple, presence of proximal and distal radioulnar synostosis in the right forearm, and accompanying symbrachydactyly suggested Poland syndrome. To the best of our knowledge this is the first case of congenital proximal and distal radioulnar synostosis with Poland syndrome.