EC Paediatrics

Research Article Volume 13 Issue 12 - 2024

Long Time Outcome of Surgical Bipolar with Z-Plasty Lengthening and Postoperative with or without Place Cast for Congenital Muscular Torticollis

Nguyen Ngoc Hung*

Surgical Department, Vietnam National Hospital for Pediatric, Ha Noi Medical University, Vietnam

*Corresponding Author: Nguyen Ngoc Hung, Surgical Department, Vietnam National Hospital for Pediatric, Ha Noi Medical University, Vietnam.
Received: October 29, 2024; Published: November 19, 2024




Objective: To evaluate the clinical and functional outcomes of a technical procedure in the surgical treatment of congenital synostosis in children.

Materials and Methods: A prospective study was conducted from January 1995 to December 2010. Fifty-five patients (Eighty-four forearms) with congenital synostosis in internal rotation were recruited. Congenital synostosis in internal rotation was classified into two types according to Tachdjian. All patients were treated by resection of the proximal radius and distal ulna and partial resection of both forearms. After intramedullary K-wire insertion into both bones, the forearms were rotated manually, followed by cast immobilization.

Results: There were 36 males (65.5%) and 19 females (34.5%). The mean age at surgery was 6 years and 9 months. The distribution was 9 right forearms and 17 left forearms; 29 patients (52.7%) had bilateral lesions. Type 1 “headless type”: 19 forearms (22.6%) and Type 2: 65 forearms (77.4%). The mean follow-up period was 19 years and 3 months. Excellent results were achieved in 24 forearms (28.6%), good results in 41 forearms (48.8%), fair results in 19 forearms (22.6%), no poor results and no complications in all patients

Conclusion: Congenital proximal radial fixation can be successfully treated by surgical resection of the radius and ulna, shortening of both bones and fixation with Kirschner wires at the radius and ulna. This technique is safe and effective

 Keywords: Congenital Radioulnar Synostosis; Radial Fixation; Radial Head Dislocation; Radial Osteotomy; Forearm Function

  1. Rutkowski PT and Samora JB. “Congenital radioulnar synostosis”. Journal of the American Academy of Orthopaedic Surgeons 13 (2021): 563-570.
  2. Barik S., et al. “Results after treatment of congenital radioulnar synostosis: a systematic review and pooled data analysis”. Journal of Pediatric Orthopaedics B 6 (2021): 593-600.
  3. Michiyo F., et al. “Rotational osteotomy at the diaphysis of the radius in the treatment of congenital radioulnar synostosis”. Journal of Pediatric Orthopaedics 5 (2005): 676-679.
  4. Miura T., et al. “Congenital radioulnar synostosis”. Journal of Hand Surgery (British Volume) 2 (1984): 153-155.
  5. Simmons BP., et al. “Congenital radioulnar synostosis”. Journal of Hand Surgery6 (1983): 829-837.
  6. Barik S., et al. “Results after treatment of congenital radioulnar synostosis: a systematic review and pooled data analysis”. Journal of Pediatric Orthopaedics B 6 (2021): 593-600.
  7. Fujimoto M., et al. “Rotational osteotomy at the diaphysis of the radius in the treatment of congenital radioulnar synostosis”. Journal of Pediatric Orthopaedics 5 (2005): 676-679.
  8. Pei X and Han J. “Efficacy and feasibility of proximal radioulnar derotational osteotomy and internal fixation for the treatment of congenital radioulnar synostosis”. Journal of Orthopaedic Surgery and Research 1 (2019): 81.
  9. Ogino T and Hikino K. “Congenital radio-ulnar synostosis: compensatory rotation around the wrist and rotation osteotomy”. Journal of Hand Surgery2 (1987): 173-178.
  10. Tachdjian MO [editors]. Pediatric Orthopaedics. Philadelphia, W.B. Saunder (1972).
  11. Blaine ES. “Congenital Radioulnar Synostosis, with Report of a Case”. Journal of Surgery 2 (1930): 429-434.
  12. Mouchet A and Leleu A. “La Synostose CongénitaleRadio-cubitale Supérieure”. d’Orthop XII (1925): 421.
  13. Stanley F. “Radio-Ulnar synostosis: Historical Review and Case Report”. Journal of Bone and Joint Surgery American Volume 2 (1932): 395-403.
  14. Michiyo F., et al. “Rotational osteotomy at the diaphysis of the radius in the treatment of congenital radioulnar synostosis”. Journal of Pediatric Orthopaedics 25 (2005): 676-679.
  15. Garland DE., et al. “Upper extremity fractures in the acute spinal cord injured patient”. Clinical Orthopaedics and Related Research 233 (1988): 110-115.
  16. Davenport CB., et al. “Radio-Ulnar Synostosis”. Archives of Surgery 3 (1924): 705-762.
  17. Simmons BP., et al. “Congenital radioulnar synostosis”. Journal of Hand Surgery (American Volume) 6 (1983): 829-838.
  18. Ogino T and Hikino K. “Congenital radio-ulnar synostosis: compensatory rotation around the wrist and rotation osteotomy”. Journal of Hand Surgery (British Volume) 2 (1987): 173-178.
  19. Cleary JE and Omer GE. “Congenital proximal radio-ulnar synostosis. Natural history and functional assessment”. Journal of Bone and Joint Surgery American Volume 4 (1985): 539-545.
  20. Griffet J., et al. “Les synostoses congénitales radio-cubitales supérieures. A propos de 43 cas”. International Orthopaedics 10 (1986): 265-269.
  21. Poureyron Y., et al. “Surgery of congenital radio-ulnar synostosis. Technical error and therapeutic strategy”. Revue de Chirurgie Orthopedique et Reparatrice de l'Appareil Moteur 1 (1996): 80-84.
  22. Funakoshi T., et al. “The use of pedicled posterior interosseous fat graft for mobilization of congenital radioulnar synostosis: a case report”. Journal of Shoulder and Elbow Surgery 2 (2004): 230-234.
  23. Fumino K and Kunio I. “Mobilization of a congenital proximal radioulnar synostosis with use of a free vascularized fascio-fat graft”. Journal of Bone and Joint Surgery 8 (1998): 1186-1192.
  24. Tadanao F., et al. “The use of pedicled posterior interosseous fat graft for mobilization of congenital radioulnar synostosis: A case report”. Journal of Shoulder and Elbow Surgery 2 (2004): 230-234.
  25. Wright TW and Glowczewskie F. “Vascular anatomy of the ulna”. Journal of Hand Surgery (American Volume) 5 (1998): 800-804.
  26. John F D., et al. “Ulnar Nonunion After Osteoclasis for Rotational Deformities of the Forearm”. Journal of Hand Surgery (American Volume) 6 (2006): 973-978.
  27. Szabo RM and Skinner M. “Isolated ulnar shaft fractures. Retrospective study of 46 cases”. Acta Orthopaedica Scandinavica 4 (1990): 350-352.
  28. Dalton JF., et al. “Ulnar nounion after for rotational deformities of the forearm”. Journal of Hand Surgery (American Volume) 6 (2006): 973-978.
  29. Murase T., et al. “Derotational osteotomy at the shafts of the radius and ulna for congenital radioulnar synostosis”. Journal of Hand Surgery1 (2003): 133-137.
  30. Tsuyoshi M., et al. “Derotational Osteotomy at the Shafts of the Radius and Ulna for Congenital Radioulnar Synostosis”. Journal of Hand Surgery (American Volume) 1 (2003): 133-137.
  31. Green WT and Mital MA. “Congenital radio-ulnar synostosis: surgical treatment”. Journal of Bone and Joint Surgery. American Volume 5 (1979): 738-774.
  32. Ramachandran K., et al. “Rotational osteotomies for congenital synostosis”. Journal of Bone and Joint Surgery. British Volume 10 (2005): 1406-1410.
  33. Simmons BP., et al. “Congenital radioulnar synostosis”. Journal of Hand Surgery6 (1983): 829-837.
  34. Castello JR., et al. “Congenital radiounar synostosis. Surgical correction by derotation osteotomy”. Annales de Chirurgie de la Main et du Membre Supérieur 1 (1996): 11-17.

Nguyen Ngoc Hung. "Long-Term Outcome of Corrective Derotation Osteotomies to Treat Congenital Radioulnar Synostosis in Children". EC Paediatrics 13.12 (2024): 01-16.

ECronicon Journal

Our Services

Quick Links

Information

Creative Commons LicenseOpen Access by ECronicon is licensed under a Creative Commons Attribution 4.0 International License
Based on a work at www.ecronicon.net