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Children's Orthopaedics: M. Ramachandran, K. Lau, and D. H. A. Jones Rotational osteotomies for congenital radioulnar synostosis J Bone Joint Surg Br 2005; 87-B: 1406-1410 [Abstract] [Full text] [PDF]

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Rotational osteotomies for congenital radioulnar synostosis - the level of osteotomy

Dusko Spasovski, MD   (31 March 2006)

Rotational osteotomies for congenital radioulnar synostosis - correspondence

Zoran S Vukasinovic, Ismet Gavrankapetanovic, Goran Cobeljic, and Jean Marian Patrascu   (22 March 2006)

Rotational osteotomies for congenital radioulnar synostosis - the level of osteotomy 31 March 2006
Dusko Spasovski, MD, Specialist registrar Institute for Orthopaedic Surgery and Traumatology, Clinical Centre of Serbia Send letter to journal: Re: Rotational osteotomies for congenital radioulnar synostosis - the level of osteotomy dukica{at}verat.net Dusko Spasovski, MD	Sir, We read this paper with interest. Functional results of a fixed post-operative forearm position in slight supination, as reported by the author, are good for unilateral cases, and can be improved only by more complicated and demanding procedures.1 As to operative technique, a one-incision approach and large area of bony contact seem to be important advantages of a trans-synostotic osteotomy site, as stated in correspondence. Promising results of the separation of the synostosis with a microvascular graft interposed offer an alternative in bilateral cases.2 The reported results should be further evaluated to reflect the operative side (dominant or non-dominant) and the status of the contralateral forearm (unilateral or bilateral synostosis). D. Spasovski, MD, Institute for Orthopaedic Surgery and Traumatology, Serbia. 1. Huang-Kai K, Hung-Chi C, Hwan-Tan C. Congenital Radioulnar Synostosis Treated Using a Microvascular Free Fascio-Fat Flap. Chang Gung Med J 2005;28:117-22. 2. Poureyron Y, Caro P, Dubrana F, Le D, Lefevre C. Surgery in congenital radio ulnar synostosis. Technical error and therapeutic strategy. Rev Chir Orthop Reparatrice Appar Mot. 1996;82:80-84.
Rotational osteotomies for congenital radioulnar synostosis - correspondence 22 March 2006
Zoran S Vukasinovic, pediatric orthopaedic surgeon Institute for Orthopaedic Surgery, Ismet Gavrankapetanovic, Goran Cobeljic, and Jean Marian Patrascu Send letter to journal: Re: Rotational osteotomies for congenital radioulnar synostosis - correspondence zvukasin{at}beotel.yu Zoran S Vukasinovic, et al.	Sir, With regard to the article by Ramachandran M et al, we would like to congratulate the authors upon their excellent results. We have just finished a multicentre study (Belgrade-Serbia and Montenegro, Sarajevo-Bosnia and Herzegovina and Timosoara-Romania) concerning this problem. In contrast to the authors, we have used three different surgical procedures (isolated derotation osteotomy of the radius in seven cases, longitudinal separating osteotomy of the synostosis in six cases, and transversal derotation osteotomy of the synostosis in 11 cases). By the first method we achieved good and long-lasting correction in only three cases (42.8%). All the cases treated by the second method had elbow ankylosis and lack of the correction. The best results were achieved by the last method, in all 11 cases (100%), with a lot of advantages: one skin incision, extensive osteotomy site for easy fixation (easily removable Kirschner wires), union in all cases and subsequently no relapses. We hope that you will appreciate our contribution. Z. Vukasinovic, MD, PhD, Belgrade, Serbia and Montenegro. I. Gavrankapetanovic, MD, PhD, Sarajevo, Bosnia and Herzegovina. G. Cobeljic, MD, PhD, Belgrade, Serbia and Montenegro. J.M. Patrascu, Timisoara, Romania. 1. Djoric I, Vukasinovic Z. Radioulnar synostosis - our 20 years experience. Acta Orthop Iugosl 2002;33:24-28. 2. McCluskey WP,Costas BL. Surgery of Upper Extremity Malformations: Complications and Management. In: Epps CH, Bowen JR (Eds). Complications in Pediatric Orthopaedics Surgery. Philadelphia: JB Lippincott Company,1995:329-331.