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Journal of the American Academy of Orthopaedic Surgeons
Post-traumatic RUS is a rare complication of forearm / elbow fractures. Early surgery 6-12 months after the initial injury can be helpful if the fused bone is completely taken out.
Read full article (opens in a new tab)Orthopaedics & Traumatology: Surgery & Research
Adult post-traumatic RUS is a rare complication of forearm fractures that completely blocks forearm rotation. Risk factors include fractures of both bones at the same level or extensive soft-tissue damage, and delayed or repeated surgery / single surgery for both bones. While there is no clear consensus on the treatment approach, individual planning and intensive rehab is important.
Read full article (opens in a new tab)Journal of Shoulder and Elbow Surgery
This study looked at adults who developed this problem in the forearm after an injury and then had surgery with one surgeon. Most people had the abnormal bone bridge removed (sometimes with extra procedures) and their arm function scores improved a lot after surgery. Surgery usually worked well, but it could still fail or have hardware problems, so planning each operation carefully was important.
Read full article (opens in a new tab)journals.lww.com
Seven adults with post‑traumatic proximal radioulnar synostosis had a small segment of the proximal radius (about 1 cm) removed just below the fused area. Forearm rotation improved from almost no movement (about 5°) to an average arc of 98° after surgery, and functional scores also rose noticeably. Complications included one case of re‑stiffening at the resection site and one case of temporary ulnar nerve numbness.
Read full article (opens in a new tab)tandfonline.com
Recommended management for posttraumatic RUS includes optimizing the original fracture surgery to avoid bone debris between the bones, then another surgery to resection the bridge once the bone has matured, usually around 6-12 months. Other treatments like NSAIDs or low‑dose radiation and early, intensive rehab are reserved for higher‑risk cases.
Read full article (opens in a new tab)sciencedirect.com
Preferred treatment of posttraumatic RUS is surgical excision of the bony bridge once fractures have healed or the synostosis looks stable on X‑ray, sometimes with a tissue layer placed between the bones. Various interposition materials and rehabilitation plans are reported, but no single option clearly works best in all patients.
Read full article (opens in a new tab)sciencedirect.com
A 21‑year‑old man developed proximal radioulnar synostosis ten months after fractures of the proximal radius and ulna. The bony bridge between the two bones was cut out and a vascularized posterior interosseous island forearm flap was placed between them to keep the bones separated. Forearm rotation improved without recurrence of the bridge at follow‑up, showing that this flap method can maintain motion after resection.
Read full article (opens in a new tab)onlinelibrary.wiley.com
Two adults developed post‑traumatic radioulnar synostosis after high‑energy forearm fractures with major soft‑tissue damage and delayed mobilization. Surgery removed the bony bridge and wrapped both radius and ulna with a strip of strong donor thigh tissue (allogenic fascia lata graft) to block new bone from growing between them. At 2‑year follow‑up, both patients had full forearm rotation, no pain, and no recurrence on X‑ray.
Read full article (opens in a new tab)journals.lww.com
A 43‑year‑old man developed proximal radioulnar synostosis nine months after a Monteggia fracture that had been fixed with a plate. X‑rays and CT showed a bridge between the proximal radius and ulna, so surgeons removed the implant and excised the bridge. After surgery and physiotherapy, forearm rotation improved to nearly full pronation and supination, and daily activities were easier.
Read full article (opens in a new tab)journals.sagepub.com
Two adults with post‑traumatic radioulnar synostosis had the bony bridge removed and a local adipofascial flap (fat and fascia with its blood supply) placed between radius and ulna. At follow‑up, both regained a useful arc of forearm rotation and returned to daily activities with less difficulty. No recurrence of the bridge or major complications were reported, suggesting this flap can help keep the bones from re‑fusing.
Read full article (opens in a new tab)sciencedirect.com
The article summarizes how to time surgery (usually 6-12 months after injury when extra bone has matured) and explains which open surgical approach to choose based on where the bridge is and how far it extends. After excision, covering the raw bone with interposition tissue and starting early motion are recommended to lower the risk of the bridge growing back.
Read full article (opens in a new tab)sciencedirect.com
An adult developed proximal radioulnar synostosis from heterotopic bone after a metal radial head replacement. Surgery removed the extra bone between radius and ulna and placed a soft‑tissue barrier (such as acellular dermal matrix) to reduce the chance of it growing back. Forearm rotation improved after surgery, and no early recurrence of the bony bridge was reported.
Read full article (opens in a new tab)sciencedirect.com
A 43‑year‑old man in Nepal developed proximal radioulnar synostosis nine months after a Monteggia fracture that had been fixed with a plate. Imaging showed a bony bridge between the proximal radius and ulna, and surgeons removed this bridge along with the hardware. Forearm rotation improved after surgery and physiotherapy, and the report stresses that loss of pronation–supination after forearm fractures should raise suspicion for synostosis.
Read full article (opens in a new tab)jshoulderelbow.org
Adults with proximal radioulnar synostosis after trauma had the bony bridge removed and the anconeus muscle swung in between the radius and ulna as a living tissue spacer. Most patients gained a useful arc of forearm rotation and better elbow use in daily activities. Recurrence of the bridge was uncommon, showing that anconeus interposition can give reliable motion with a low complication rate.
Read full article (opens in a new tab)journals.lww.com
A 16‑year‑old boy broke the distal ulna with a minimally displaced greenstick fracture and was treated in a cast and then a splint. Three months later, he returned with complete loss of forearm rotation, and imaging showed a distal radioulnar synostosis. Surgical removal of the bony bridge restored forearm motion, and no recurrence was seen on follow‑up.
Read full article (opens in a new tab)sciencedirect.com
Ten adults with post‑traumatic radioulnar synostosis in Kuwait needed surgery because forearm rotation was severely blocked. Most had the bony bridge removed, often with tissue placed between radius and ulna and followed by rehab, which improved their pronation-supination arc and daily function. Complications and recurrences were uncommon in this series, but the paper stresses careful planning and early motion after surgery to protect the result.
Read full article (opens in a new tab)pmc.ncbi.nlm.nih.gov
A 26‑year‑old man with previously unrecognized CRUS sustained a fracture through the fused segment after a road traffic accident. Open reduction and internal fixation with a plate plus early, structured rehabilitation led to solid bone healing and near‑normal forearm motion by 6 months. The report shows that fractures through a CRUS segment can be fixed surgically with good function when the anatomy is carefully evaluated.
Read full article (opens in a new tab)saspublishers.com
A 55‑year‑old woman developed radioulnar synostosis after an open both‑bone forearm fracture treated with intramedullary wires, where leftover fragments filled the interosseous space. Nine months later, the forearm was fixed with loss of pronation, and imaging showed a solid bone bridge between radius and ulna. Surgical excision of the bridge without interposition tissue, plus early physiotherapy, restored good pronation-supination by 12 months with no recurrence.
Read full article (opens in a new tab)sciencedirect.com
A patient developed radioulnar synostosis as a complication after a complex elbow injury that included fractures and ligament damage. Imaging showed abnormal bone formation connecting the radius and ulna, which caused loss of forearm rotation. Surgical excision of the bony bridge with appropriate fixation and rehabilitation improved motion and reduced pain.
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)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)academic.oup.com
A 7-year-old boy developed distal radioulnar synostosis after a high-energy road traffic accident and initial open reduction and fixation of both forearm bones. One year later, synostosis resection with interposition of autologous fat restored full forearm rotation, with no recurrence at 16-month follow-up. A brief review of recent pediatric cases shows that early surgical resection with or without biological interposition with early rehabilitation usually leads to good motion and low recurrence.
Read full article (opens in a new tab)assets.cureus.com
A 42-year-old woman developed proximal radioulnar synostosis after a conservatively treated radial head fracture, which caused severe loss of forearm rotation. Surgical excision of the bony bridge with an anconeus muscle flap placed between the radius and ulna restored functional pronation and supination. At follow-up, forearm motion remained good with no recurrence of the synostosis or major complications.
Read full article (opens in a new tab)sciencedirect.com
Sixty-three adults with same-level fractures of both forearm bones were treated with elastic stable intramedullary nailing and followed for at least one year. Bone healing occurred in all patients, and only one person (1.2%) developed radioulnar synostosis at the middle third of the forearm. Overall arm function scores were good or excellent in almost all cases, and open fractures or open reductions did not delay healing.
Read full article (opens in a new tab)link.springer.com
One adult with extensive post-traumatic radioulnar synostosis from the proximal to distal forearm had almost no forearm rotation. Treatment involved wide excision of the bony bridge combined with a free vascularized flap placed between the radius and ulna plus postoperative rehabilitation to allow rotation. Forearm motion and function improved without recurrence of the synostosis at follow-up.
Read full article (opens in a new tab)sciencedirect.com
Adults with post-traumatic radioulnar synostosis were treated by wide excision of the bony bridge plus interposition of a free fat flap between the radius and ulna. Most patients regained useful pronation and supination with low recurrence rates after surgery. The series supports using radical excision with soft-tissue interposition to lower the chance of the bones re-fusing while improving arm function.
Read full article (opens in a new tab)sciencedirect.com
Two adults with proximal radioulnar synostosis after trauma were treated by removing the bony bridge and filling the gap with a posterior interosseous adipofascial flap that keeps its own blood supply. The flap was rotated into the space between the radius and ulna and anchored through a small skin button so it stayed in place while early motion began. Forearm rotation improved, and no synostosis recurrence was seen at follow-up, suggesting this living pedicled flap is a reliable way to prevent the bones from re-fusing.
Read full article (opens in a new tab)scielo.br
An adult with a “floating elbow” from high-energy trauma was treated with a humeral plate and intramedullary nails in the radius and ulna, then later developed radioulnar synostosis and radial nerve injury. CT scans showed a bony bridge between the radius and ulna in the proximal-mid forearm, causing loss of forearm rotation. Because elbow motion and function were acceptable and nerve recovery was progressing, no further surgery for the synostosis was performed, and the case highlights that intramedullary nailing plus severe trauma can increase synostosis risk.
Read full article (opens in a new tab)link.springer.com
A 70-year-old man developed proximal radioulnar synostosis with nonunion of the radial neck after a forearm injury and internal fixation. Surgical treatment included excision of the synostosis, bone grafting of the radial neck, and plate fixation to restore elbow and forearm function. Pain and motion improved after surgery, and the case highlights the need to consider synostosis plus nonunion when evaluating persistent elbow pain after trauma.
Read full article (opens in a new tab)link.springer.com
An adult developed proximal radioulnar synostosis exactly where an external fixator pin had crossed the forearm after a fracture. Surgical excision of the bony bridge restored forearm rotation and improved arm use. The report stresses careful pin placement during external fixation and early follow-up to catch this rare but serious complication.
Read full article (opens in a new tab)journals.lww.com
Two children developed radioulnar synostosis after forearm injuries and were treated surgically once the bony bridge had matured. One child had simple excision of the synostosis, and the other had excision plus placement of a soft-tissue interposition flap between the radius and ulna. Both regained useful pronation and supination with no early recurrence, showing that carefully timed resection can restore rotation in growing children.
Read full article (opens in a new tab)link.springer.com
An adult with post-traumatic proximal radioulnar synostosis is used to illustrate a step-by-step surgical technique for removing the bony bridge between radius and ulna. The operation includes careful exposure, wide excision of the synostosis, and soft-tissue interposition to keep the bones apart while healing. Forearm rotation improved after surgery, and the report emphasizes technical points that help lower the risk of recurrence.
Read full article (opens in a new tab)journals.sagepub.com
A 52‑year‑old woman developed proximal radioulnar synostosis from heterotopic bone after a metal radial head replacement for an elbow fracture. The abnormal bone bridge formed between the radius and ulna and blocked forearm rotation. Excision of the heterotopic bone improved motion, and the report discusses strategies to prevent and treat this kind of heterotopic ossification around the elbow.
Read full article (opens in a new tab)boneandjoint.org.uk
The piece outlines different ways to manage post-traumatic radioulnar synostosis, including timing of surgery, how much bone to remove, and whether to add soft-tissue or flap interposition between the radius and ulna. Advantages and drawbacks of these options are compared, with emphasis on preventing recurrence and restoring useful forearm rotation. A practical treatment strategy is proposed to help surgeons choose the best approach based on synostosis location, patient needs, and risk factors.
Read full article (opens in a new tab)pmc.ncbi.nlm.nih.gov
One adult with long-standing post-traumatic radioulnar synostosis in the distal third of the forearm underwent excision of the bony bridge through a volar approach. The surgeon wrapped the patient’s own palmaris longus tendon around the exposed ulna and added free fat as an interposition layer to reduce re-ossification. At 10-year follow-up there was no recurrence of the synostosis, only modest gain in rotation, but the patient could do daily activities comfortably.
Read full article (opens in a new tab)journals.healio.com
A 9‑year‑old girl developed distal radioulnar synostosis after Kirschner‑wire (K‑wire) fixation of a distal radius fracture. A bony bridge formed between the radius and ulna near the wrist, leading to loss of forearm rotation. The report emphasizes careful wire placement and early follow‑up, because wires that cross or irritate the interosseous space may increase the risk of this rare complication.
Read full article (opens in a new tab)d1wqtxts1xzle7.cloudfront.net
A child developed proximal radioulnar synostosis after an isolated radial head fracture that had been treated nonoperatively in a cast. A bony bridge formed between radius and ulna near the elbow, severely limiting forearm rotation. Surgical excision of the synostosis restored useful pronation–supination, and the authors stress that even seemingly simple radial head fractures can rarely lead to this complication.
Read full article (opens in a new tab)onlinelibrary.wiley.com
An 8‑year‑old girl developed proximal radioulnar synostosis weeks after a minimally displaced radial neck fracture with an associated olecranon fracture that were treated only with closed reduction and casting. Over two and a half years she progressed to complete loss of forearm rotation with a large bony bridge across the proximal radioulnar joint. The authors highlight that even nonoperatively managed, mildly displaced radial neck fractures with concomitant elbow injuries can rarely lead to this complication and recommend closer radiographic and range‑of‑motion follow‑up.
Read full article (opens in a new tab)casereports.bmj.com
A man with a severe arm injury and head trauma developed a solid bone bridge between the two forearm bones, which blocked rotation. Surgeons removed the bone bridge and placed a thin tissue flap based on the radial artery between the bones to stop it from growing back. After surgery and therapy, forearm rotation and hand use improved, and no new bone bridge formed over the follow-up period.
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.
