Humeroradial and Humeroulnar Synostoses

•  Humeroradial synostosis is much more common than humeroulnar synostosis and can be divided into two types. Type I involves ulnar hypoplasia, usually is sporadic, and has an elbow usually fixed in extension. Type II is less common, usually is familial, is not associated with ulnar hypoplasia, and usually is fused in flexion.36 Both types can be associated with genetic syndromes, and extraskeletal abnormalities are present in numerous cases. Referral to a geneticist or to subspecialists is warranted.

•  Treatment of elbow synostoses depends on the position of the elbow and forearm. No procedure has successfully created and maintained a flexible elbow. These synostoses usually are unilateral and are well compensated by a normal contralateral hand. If the hand is positioned in front of the body with moderate elbow flexion and forearm pronation, surgical correction is not indicated. However, in patients in whom the elbow is positioned in such hyperextension that the hand is behind the body, corrective osteotomies through the fusion mass are recommended.

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  • Category: Surgical treatment