Humeral and radioulnar synostosis: causes, symptoms, diagnosis, treatment

Brachioradialis synostosis

Radial-humeral synostosis (Keutel et al. syndrome, 1970) is a congenital defect caused by a violation of differentiation of the bone-articular apparatus of the hand and characterized by a pronounced shortening of the upper limb, fusion of the humerus and curved radius (absence of the elbow joint), underdevelopment or absence of the ulna, aplasia of one to four rays of the hand, significant underdevelopment of muscles. The forearm is usually located at an angle of 170 to 110 ° in relation to the shoulder. The deformity is characterized by a variety of clinical signs (due to the absence of one to four rays of the hand). Correction of the deformity is possible: multi-stage orthopedic surgical treatment is performed, including lengthening of the humeroradial bone using hardware, transplantation of blood-supplied metatarsophalangeal joints, transposition of the latissimus dorsi muscle to the position of the biceps brachii muscle, and reconstructive surgery on the hand.

ICD-10 code

Q87.2 Radial-humeral synostosis.

Radioulnar synostosis

Radioulnar synostosis is a congenital defect caused by a violation of differentiation of the bone-articular apparatus of the forearm and characterized by fusion of the radius and ulna in the proximal section. Dislocation of the head of the radius is often diagnosed.

ICD-10 code

Q74.0 Radioulnar synostosis.

Symptoms and diagnosis of brachioradialis and radioulnar synostosis

Clinical signs of synostosis are usually detected from the age of 3, when the absence of pronation and supination movements of the forearm becomes noticeable. The forearm is in the pronation position. A distinction is made between bilateral deformation (with a large extent of synostosis and the presence of a common bone marrow canal of the radius and ulna) and unilateral deformation (with a smaller extent of fusion).

Subcompensation of the specified movement deficit in children is caused by rotation in the shoulder joint with the elbow joint extended, as well as excessive stretching of the tendon-ligament apparatus of the wrist joint. Touching the face is possible with the back of the hand.

Treatment of brachioradialis and radioulnar synostosis

Surgical treatment is performed in cases of severe pronation contracture of the hand (more than 15° from the average position of the hand) in order to place the forearm and hand in a functionally advantageous position (15° pronation).