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The Use of Tensor Fascia Lata Interposition Grafts for the Treatment of Posttraumatic Radioulnar Synostosis

https://doi.org/10.1016/j.jhsa.2006.02.005Get rights and content

Purpose

There is no agreement on the ideal treatment of traumatic radioulnar synostosis, especially the type of interposition material to be used. The purpose of this study is to report our experience with synostosis resection and interposition of tensor fascia lata grafts.

Methods

A chart review was conducted for all patients treated for posttraumatic radioulnar synostosis between 2000 and 2004. Demographic data, mechanism of injury, length of time to synostosis resection, range-of-motion, patient satisfaction, and postoperative complications were analyzed.

Results

Thirteen patients were identified for this study. The mean preoperative pronation was 14° and the mean postoperative pronation was 62°. The mean preoperative supination was 4° and the mean postoperative supination was 62°. The mean follow-up time was 30 months.

Conclusions

These results indicate that synostosis resection with tensor fascia lata graft interposition is an effective technique for the treatment of posttraumatic radioulnar synostosis.

Type of study/level of evidence

Therapeutic, Level IV.

Section snippets

Materials and Methods

All aspects of this study were approved by the institutional review board at our institution and informed consent was obtained from each patient involved in the study.

Patients who had been treated for complete radioulnar synostosis were identified through a review of the surgical database of all patients who had surgery performed by the senior author (D.P.H.) from 1999 to 2004. Incomplete synostoses were excluded from this study. Thirteen patients with complete synostosis were identified. The

Results

The patients had synostosis excision and interposition an average of 20 months (range, 5–132 mo) after the original injury. The patients currently have been followed up for an average of 30 months (range, 14–54 mo) after this surgery.

The only postoperative complication was 1 limited postoperative wound dehiscence with a small amount of exposed olecranon. One month after this patient’s synostosis takedown she returned for a wound debridement and revision of the closure. After this the wound

Discussion

Before the published series by Failla et al5 and Vince and Miller23 the surgical treatment of radioulnar synostosis was based largely on case reports2, 6, 8, 9, 17, 28, 29, 30, 31, 32, 33, 34, 35 involving 1 to 3 patients per series. These reports helped to substantiate a pessimistic approach toward this entity but were based on little agreement on therapeutic approach. Each held in common a hesitant agreement about the necessity of surgical resection of the bony synostosis. The aggregate,

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