Post-traumatic radioulnar synostosis: a retrospective case series of 10 patients in Kuwait

Abstract

Background: The development of radioulnar synostosis due to post-traumatic injuries of the elbow or forearm can lead to debilitating outcomes. Several treatment options are available to hinder the progression and prevent recurrence. We used a combination of these treatments in a series of patients and observed the outcomes.

Methods: We conducted a retrospective study of 10 patients with post-traumatic radioulnar synostosis (9 men and 1 woman) who required surgical intervention in a tertiary orthopedic center. All of these patients were subjected to the same treatment combination (preoperative radiotherapy, tissue interposition after heterotopic ossification resection, and adjuvant indomethacin postoperatively). Improvement in range of motion (flexion, extension, and rotation) and the Mayo score was assessed and compared preoperatively and postoperatively via statistical analysis.

Results: In comparison to the patients' preoperative state, which ranged from poor to fair, all 10 patients reported excellent Mayo scores after intervention with the triple therapy combination, with a mean Mayo score of 36 ± 10.2 points. Flexion, extension, and rotation improved by mean values of 55.2° ± 38.7°, 50.2° ± 34.0°, and 47.9° ± 40.0°, respectively. There was 1 complication that has subsided on follow-up.

Conclusion: The triple therapy combination was found to provide good functional and prophylactic results preventing recurrence.

Keywords: Radioulnar; elbow; hypertrophic ossification; post-traumatic; stiffness; synostosis.