Improving the Accuracy of Corrective Osteotomy for Congenital Radio Ulnar Synostosis using the Axis of Rotation of the Forearm as a Guide

Introduction: Despite several techniques for corrective osteotomy in congenital radioulnar synostosis (CRUS) the published literature lacks a guide for radiographic planning and rationale for the site and level of the osteotomy. The primary objective of this study is to report a technique of radiographically controlled corrective osteotomy using the axis of rotation of the forearm in CRUS.Materials and methods: Children with CRUS underwent corrective osteotomy based on radiographic planning; the extent of rotational correction and functional outcomes were assessed at a mean of 27 months after the operation.Results: Seven forearms in six children of an average of 6.25 years were assessed for correction and functional outcomes. The average pre-operative pronation deformity was 71.5 degrees. The average correction achieved was 64 degrees. At follow-up, there were five excellent and two good functional outcomes. All children could perform daily tasks besides eating with hand and personal hygiene.Conclusion: Radiographic determination of the osteotomy sites by the method described is effective, consistent, and reproducible in achieving optimal functional outcomes in congenital radioulnar synostosis.