1. Lamyaa Anwar Alghafli

2.  Anatomy of radio-ulnar joint.
 Types of radio-ulnar synostosis.
 Definition of radio-ulnar synostosis.
 Congenital radio-ulnar synostosis.
 Posttraumatic radio-ulnar synostosis.
 Clinical presentation.
 Physical examinations and Investigations.
 Management.

6.  A radio-ulnar synostosis is a rare condition which is upper limb
skeletal malformation characterized by bony fusion of the radius
and ulna.
 In 1793, Sandifort provided the initial description of congenital type.
 Gros described posttraumatic radioulnar synostosis in 1864.

7. Radio-ulnar
synostosis
Post-
traumatic
Distal
forearm
Mid
forearm
Proximal
forearm
Congenital
Proximal
forearm
Bilateral
Unilateral

8.  For a short time, the radius and ulna share a common
perichondrium.
 Abnormal events at this time can lead to a failure of segmentation.
 Usually, it’s not discover until early adolescence,
 About one third of cases are associated with general skeletal
abnormalities.

9.  The most common cause: operatively treated forearm fracture.
 Patients with high-energy, comminuted, open fractures.
 Monteggia and proximal forearm fractures.
 The use of bone graft and screws protruding through the opposite
cortex.
 Any trauma causing hematoma formation.

11.  Hypermobility at the wrist joint.
 Pain.
 Disability.

12. Physical examinations:
 pronation and supination blocked
both actively and passively.
Investigations:
 Radiographs:
AP and lateral of forearm, elbow, and wrist.

13.  non operative:
 Observation.
 Operative:
 osteotomy with fusion.
 surgical resection of synostosis, irradiation, and indomethacin.
 proximal radial excision.
 Postoperative rehabilitation:
 Splinting in maximum pronation and supination between passive
and active physiotherapy.

14.  Clinical ATLAS of human anatomy, Peter H, Johannes M, Jonathan D.
 Radioulnar synostosis : A case report, Ramakrishna Avadhani , Bindhu S. ,
Vikram , Dhanesh Kumar K.U.& Arunachalam Kumar
 http://emedicine.medscape.com/article/1240467-overview#a0102
 http://www.orthobullets.com/trauma/1026/radioulnar-synostosis
 http://www.sciencedirect.com/science/article/pii/S1877056812001582

15.  http://www.ncbi.nlm.nih.gov/pubmed/23789710
 http://www.wheelessonline.com/ortho/radioulnar_synostosis
 http://www.childrenshospital.org/conditions-and-
treatments/conditions/r/radioulnar-synostosis/treatments
 http://radiopaedia.org/articles/proximal-radio-ulnar-synostosis