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Journal of Pediatric Orthopaedics B
Surgery can improve quality of life for children with CRUS by correcting severe fixed pronation, but all methods carry complication risks related to the hardware used to secure rotational osteotomies.
Read full article (opens in a new tab)Polish Journal of Radiology
A 10-year-old boy with CRUS had CT/3D imaging to precisely show the fused segment. The surgeons performed a derotational osteotomy of the radius with plate-and-screw fixation, and later removed the hardware to start rehab, which led to substantial improvement in upper-limb function.
Read full article (opens in a new tab)boneandjoint.org.uk
Five children with severe fixed forearm rotation from this condition had rotational osteotomies on six forearms. Forearms were rotated to a more useful position and fixed with hardware, which improved daily use of the arm for most patients. Since complications such as nerve problems and compartment syndrome occurred in some cases, especially with large corrections, careful planning and monitoring are crucial.
Read full article (opens in a new tab)link.springer.com
The study tested a surgery that rotates the fused part of the radius and ulna and holds it with a plate in children with this condition. Forearm position and function improved in most patients, with better ability to use the hand in daily activities. Complication and recurrence rates were low, showing that this operation is generally safe and workable when done with careful technique.
Read full article (opens in a new tab)journals.lww.com
Children with CRUS underwent derotational osteotomy to move the forearm into a more useful position. Forearm rotation and function improved in nearly all patients, with a much lower complication rate than older reports. Careful control of the bone cut, stable pin fixation, and routine release of tight muscle compartments helped reduce nerve and circulation problems.
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Multiple children with CRUS and severe fixed forearm rotation underwent derotational osteotomy, usually cutting through the fused segment and holding the bones with wires or other fixation. Most patients moved from a very pronated position into a more neutral or useful position, which made daily activities like eating and self‑care easier. Complications such as nerve symptoms and loss of correction occurred in some cases.
Read full article (opens in a new tab)journals.sagepub.com
Thirty‑four children with CRUS and fixed pronation had derotational osteotomies at the shafts of the proximal radius and distal ulna, with small bone segments removed from both bones. The average forearm position improved to a more useful range, and most children were able to do daily tasks more easily after surgery. Complications were few and bone healing was reliable, showing that this two‑level osteotomy gives predictable correction.
Read full article (opens in a new tab)journals.sagepub.com
Computer‑aided design and 3D printing were used to plan rotational osteotomies for CRUS in a small group of patients. Patient‑specific cutting guides helped surgeons rotate the bones to the planned angle more accurately and reduced errors in the final forearm position. Forearm function and satisfaction improved, with no major complications linked to the guides.
Read full article (opens in a new tab)sciencedirect.com
Children with CRUS had corrective osteotomies planned using X‑rays to find the true axis of forearm rotation and choose precise cut levels. Average fixed pronation of about 71° was improved by roughly 64°, and most children ended up with excellent or good function and could handle daily tasks independently. The planning method produced consistent corrections across seven forearms and avoided major complications.
Read full article (opens in a new tab)journals.lww.com
Children with CRUS and fixed pronation had derotational osteotomies at the shafts of both the radius and ulna, with small bone segments removed and the forearm rotated to a better position. Average forearm rotation position improved from strong pronation to near‑neutral, and daily function improved in most patients. Bone healing was reliable and complications were uncommon, showing this shaft‑level two‑bone osteotomy is an effective correction method.
Read full article (opens in a new tab)journals.eco-vector.com
Twelve children (16 forearms) with CRUS had surgery, mostly derotational osteotomy at the synostosis level using wires, and two older children also needed an extra corrective radial osteotomy with plate fixation. All forearms were moved into a neutral functional position, with better self‑care, writing, and daily activities at 1-5 years of follow‑up, and no loss of elbow motion or deformity recurrence. Temporary radial nerve branch neuropathy occurred after 5 of 16 surgeries and one delayed bone healing happened after the two‑level osteotomy, but all nerve symptoms resolved and union was eventually achieved.
Read full article (opens in a new tab)sciencedirect.com
A 10‑year‑old girl with difficulty turning both forearms had X‑rays that showed bilateral proximal CRUS. Imaging, including CT, was used to map the fused segment and plan surgery. A corrective osteotomy was performed, and the report emphasizes how detailed imaging helped choose the cut level and correction angle for better function.
Read full article (opens in a new tab)journals.sagepub.com
Bilateral CRUS in one patient was treated using a modified “reverse Sauvé‑Kapandji” procedure that combines derotational osteotomy with creating a new pseudo‑joint distally. Forearm rotation and hand use improved on both sides after surgery, giving better function in daily tasks. The report shows that this reverse Sauvé‑Kapandji approach can correct severe fixed rotation in CRUS without major complications.
Read full article (opens in a new tab)journals.sagepub.com
Children with CRUS and severe fixed pronation had a one‑stage rotational osteotomy at the proximal ulna and distal radius, with small bone segments removed. Forearms were rotated into a more useful position, and most patients showed better use of the hands in daily life. Bone healing was reliable and complications were few, indicating this single‑stage two‑level osteotomy is a safe and effective option.
Read full article (opens in a new tab)mdpi.com
Children with CRUS in several hospitals were checked to see how they did with and without surgery. Surgery that rotated the forearm bones closer to neutral improved arm position by about 60° and helped most children use their arms better, with fewer than 1 in 10 having problems. Some children with mild deformity did well without surgery, but those with very strong fixed pronation gained more independence in daily tasks after derotational osteotomy.
Read full article (opens in a new tab)sciencedirect.com
Children with CRUS had an osteotomy at the synostosis level, and the forearm was slowly rotated into a better position using a circular external fixator. Gradual correction improved the resting position of the forearm and made daily activities easier, especially tasks like eating and self‑care. The method allowed large corrections with good bone healing and few nerve or blood‑flow problems, because rotation was spread out over time instead of done all at once.
Read full article (opens in a new tab)actaorthopaedica.be
Nine children with severe CRUS had a two‑stage, double‑level rotational osteotomy of both radius and ulna, first cutting the bones and later rotating the forearm into a better position in a cast. Average fixed pronation improved from about 76° to 20-30° pronation in dominant arms and 20° supination in non‑dominant arms, with solid bone healing in about 6 weeks and no loss of correction. No nerve, blood‑flow, or elbow‑motion problems occurred, and all children showed clear improvement in daily tasks like eating, washing, and writing.
Read full article (opens in a new tab)sciencedirect.com
Children with CRUS fixed in strong pronation had derotational osteotomies at the shafts of both radius and ulna to turn the forearm into a more useful position. Average forearm position moved from heavy pronation to near neutral or slight pronation, and all bones healed without major problems. No nerve or blood‑flow complications were reported, so this two‑bone shaft osteotomy was considered a simple and safe way to correct forearm position.
Read full article (opens in a new tab)frontiersin.org
Ten children with proximal CRUS (12 forearms) had derotational osteotomies of the distal radius and proximal ulna fixed with plates, moving the forearm from an average of about 57° pronation to around neutral, with roughly 53° of correction. All osteotomies healed, Failla function scores improved from mostly fair/poor to mostly good/excellent, and no nerve, blood‑flow, or infection problems were reported. The paper also summarizes other osteotomy methods and supports plate‑fixed two‑bone derotation between ages 3-9 as a safe way to place the forearm in a more useful position.
Read full article (opens in a new tab)sciencedirect.com
Twelve children with proximal CRUS (14 forearms) and strong fixed pronation had a minimally invasive, single‑session double‑level rotational osteotomy of both radius and ulna using intramedullary K‑wires for fixation. The average forearm position was moved from heavy pronation into a more neutral or slightly pronated functional range, and most children gained easier use of the hands in daily life. All osteotomies healed without major nerve or blood‑flow problems, and the technique avoided large scars or a second surgery to remove plates.
Read full article (opens in a new tab)journals.lww.com
Children with CRUS and strong fixed pronation had a two‑stage, double‑level intraperiosteal derotational osteotomy of both radius and ulna. The forearm was rotated into a more useful position and held with casts, and most children showed better use of the hand in daily life. Bone healing was reliable with few complications, so this technique was considered a safe and simple option for severe deformity.
Read full article (opens in a new tab)link.springer.com
Adults with long‑standing proximal radioulnar synostosis and a dislocated radial head had the radial head and proximal radius removed down to the end of the fused segment, and the cut radial shaft was wrapped with a strip of thigh tissue (tensor fascia lata graft). Elbow bending and straightening improved, painful catching stopped, and patients could do daily activities more easily, even though forearm rotation stayed limited. The operation was simple, did not need special implants, and gave good pain relief and function in these delayed adult cases.
Read full article (opens in a new tab)nature.com
A computer tool was built to automatically plan osteotomy angles for CRUS using both 2‑D and 3‑D optimization. The method aimed to choose cutting planes that move the forearm into a more useful position while keeping bone shape and joint alignment close to normal. Tests on patient scans showed more accurate and personalized plans than standard manual planning.
Read full article (opens in a new tab)journals.sagepub.com
Twelve children with CRUS (14 forearms) and strong fixed pronation had a minimally invasive, single‑session double‑level rotational osteotomy of both forearm bones using intramedullary K‑wires. The average forearm position changed from marked pronation to a more neutral or slightly pronated angle, and most children showed better use of the hand in daily life. All osteotomies healed without major nerve or blood‑flow problems, and scars were small because only short incisions were needed.
Read full article (opens in a new tab)journals.sagepub.com
Children with proximal CRUS and a posteriorly dislocated radial head had a modified Kanaya osteotomy that changes where the bone is cut compared with the original procedure. The change in osteotomy site led to better forearm rotation, especially improved supination, in most treated arms. Complications were limited, so this modified technique was considered a useful option for this specific deformity pattern.
Read full article (opens in a new tab)sciencedirect.com
Children with severe CRUS deformity had derotational osteotomies to turn the forearm from heavy pronation into a more useful position. Most osteotomies were done through the synostosis and fixed with intramedullary wires or other devices, and bones healed in about 6-8 weeks. Forearm position and ability to do daily tasks improved, but osteotomies done directly at the synostosis had higher risks of nerve and blood‑flow problems than those done at the shafts.
Read full article (opens in a new tab)journals.lww.com
Two people with post-traumatic radioulnar synostosis were treated by excising the bony bridge, inserting a free vascularized fat flap, and applying a dynamic splint to allow forearm rotation. After this approach, both patients gained useful pronation and supination without early recurrence of the synostosis. The combination of a vascularized fat graft as a living barrier and early motion reduced stiffness and improved arm function.
Read full article (opens in a new tab)clinical-medicine.panafrican-med-journal.com
Ten children with radioulnar synostosis and severe pronation deformity underwent derotation osteotomy at the synostosis site with K-wire fixation and casting. Average correction of the forearm position was 54 degrees, and nine children reported better ability to do daily activities after surgery. One child developed compartment syndrome leading to nonunion and forearm shortening, and complication risk was higher at older ages.
Read full article (opens in a new tab)journals.lww.com
One adult developed distal radioulnar synostosis as a rare complication after percutaneous fixation of distal radius and ulnar styloid fractures. Surgical management with a modified Sauvé-Kapandji-type derotational procedure restored useful forearm rotation and wrist function. No recurrence of the synostosis or major complications were reported at follow-up, and daily activities were performed without major limitation.
Read full article (opens in a new tab)sciencedirect.com
A 7‑year‑old boy developed proximal radioulnar synostosis after high‑energy trauma to the elbow and forearm. Surgical treatment used a modified derotational osteotomy with excision of the bony bridge and soft tissue interposition to restore rotation. Forearm motion and daily function improved after surgery, with no recurrence of the synostosis at follow‑up.
Read full article (opens in a new tab)kjms.com.pk
Twelve children with radioulnar synostosis and severe fixed pronation underwent derotation osteotomy through the fusion mass, rotating the forearm to about 10-20 degrees of supination and fixing it with K‑wires and a cast. Bone healing occurred in all patients in about seven weeks on average, with a mean rotational correction of about 78 degrees and clear improvement in daily activities like eating and handling objects. One child developed temporary posterior interosseous nerve palsy and another developed a mild ischemic contracture, but overall satisfaction and function were good after surgery.
Read full article (opens in a new tab)pmc.ncbi.nlm.nih.gov
Twenty children with congenital proximal radioulnar synostosis and severe fixed pronation were treated using a two-stage double-level rotational osteotomy of the radius and ulna. Forearms were gradually corrected into a more functional position with external fixation, leading to large improvements in forearm position and daily activities. Complications included transient nerve symptoms and occasional loss of some correction, but overall function and satisfaction were high.
Read full article (opens in a new tab)sciencedirect.com
A child with congenital radioulnar synostosis had 3D CT scans used to create printed bone models and cutting guides for a planned rotational osteotomy. Surgeons used these patient-specific guides during proximal ulna-radius derotational osteotomy to place the forearm in a better functional position. Forearm position and daily arm use improved after surgery, showing that 3D printing can help plan and perform precise osteotomies in this condition.
Read full article (opens in a new tab)doi.org
Children with radioulnar synostosis and severe fixed pronation underwent derotational osteotomy of the proximal radius and distal ulna to place the forearm in a more useful position. After surgery, most patients showed clear improvement in daily tasks like eating, washing, and writing, with stable bone healing. Complications such as nerve irritation or partial loss of correction were uncommon and generally manageable, so overall function and satisfaction were good.
Read full article (opens in a new tab)journal.rniito.org
Many different osteotomy techniques for kids with radioulnar synostosis are summarized, focusing on what age to operate, how much to rotate the forearm, and where to cut the bones. Most children had surgery around age 5, bones usually healed in about 6–8 weeks, and target positions were near neutral or slight pronation/supination depending on side and whether one or both arms were involved. Cutting directly through the synostosis carried a much higher risk of nerve and blood vessel problems than cutting both forearm bones away from the fusion area.
Read full article (opens in a new tab)journals.ekb.eg
Children with congenital radioulnar synostosis and severe fixed forearm pronation underwent derotation osteotomy to place the forearm in a more functional position. The operations were done at the radius and/or ulna, not by resecting the synostosis itself, and most patients achieved near-target resting angles with improved ability to perform daily tasks. Reported complications were infrequent, supporting derotation osteotomy as a useful option when conservative treatment is not enough.
Read full article (opens in a new tab)journals.sagepub.com
Forearms fixed in heavy inward rotation were corrected in one surgery by cutting and rotating the bones into a more functional position. Most patients kept good correction over time and could use their hands better in daily activities. Nerve problems and other complications were uncommon and usually improved, showing this method as a workable option when motion is severely limited.
Read full article (opens in a new tab)journals.eco-vector.com
Six children with this condition had a bone cut through the fused area and the forearm was rotated into a more useful position, then fixed with pins. All arms healed in about 6–7 weeks, and the children could more easily eat, dress, and do self-care tasks after surgery. Only one child had mild, temporary nerve irritation that went away within about 12 days, supporting this method as effective and relatively safe.
Read full article (opens in a new tab)These summaries are a starting point, not medical advice or a substitute for reading each paper. Study methods, quality, and conclusions vary. Follow the source link for the full publication and discuss personal medical questions with a qualified clinician.
