The Posttraumatic Proximal Cross-union of the Forearm in Childhood: What is Recommended?

Post-traumatic Radioulnar Synostosis in Distal Forearm Fractures in Children: A Report of 2 Cases

CASES

Two pediatric cases of post-traumatic distal radioulnar synostosis are reported, accompanied by a literature review summarizing evidence on the management of these conditions. Radioulnar synostosis is a rare complication of distal forearm fractures, which impairs upper-extremity function. The numerous surgical procedures that have been described to treat this condition in adults typically involve synostosis resection and an interposition graft to reduce recurrence. The optimal treatment in children has not been established.

CONCLUSIONS

Post-traumatic radioulnar synostoses are rare conditions in pediatric patients who can be successfully treated with surgical excision of the synostoses and without the use of interposition grafting.

Pediatric Radioulnar Synostosis after Olecranon Fracture: A Case Report

Radioulnar synostosis which develops after treatment of isolated olecranon fracture is a rare complication. The aim of this study was to determine the clinical findings and postoperative outcomes of radioulnar synostosis after isolated olecranon fracture in a child patient. A 14-year-old girl was evaluated after falling on her left elbow. She had pain, edema, and motion limitation in her left elbow. After radiologic examinations, diagnosis of olecranon fracture was made. Olecranon fracture was fixated by open reduction and internal fixation with tension band wiring method via the posterior approach. When the patient came to the control to remove the implants 9 months after the first operation, there was a limitation in the supination and pronation movements. In the radiographs, synostosis was observed in the proximal region between the radius and ulna. The patient was reoperated to remove the implants. In the same session, synostosis was excised by using the posterior approach, and a barrier between the bones was constituted with bone wax and early elbow range of motion exercises started. In the postoperative first month, the patient had full flexion and extension but with 30 degrees of supination deficit. Radioulnar synostosis is rare but can be seen after isolated olecranon fractures. Early elbow motion after radioulnar synostosis surgery helps the patient to increase joint movement.

Pediatric Terrible Triad Injury of the Elbow: A Rare and Easily Missed Injury: A Case Report

CASE

We report the case of a pediatric terrible triad injury of the elbow consisting of an ulnohumeral dislocation, a radial neck fracture, and a coronoid chondral injury, which was diagnosed at 14 days following injury. We describe our surgical technique and provide details of the postoperative course, including the development of a rotational contracture following heterotopic ossification.

CONCLUSION

We describe a rare and challenging injury that should be recognized early and managed surgically to maintain acceptable elbow function.