Fracture in Humeroradial Synostosis: Description of Two Clinical Cases^[*]

Abstract

Synostosis is a generic term to indicate the union of two originally separated bones. At the elbow, humeroradial or longitudinal synostosis causes significant disability, which varies depending on hand function, elbow positioning, adjacent joints mobility and contralateral limb function. It is estimated that, to date, a little more than 150 patients have been described with this deformity, which is more common in subjects with deficient ulnar formation or affected by conditions such as Antley-Bixler and Hermann syndromes. The lack of the elbow joint, with the formation of a longer bone due to humerus-radius fusion, results in stiffness. As such, it is assumed that fractures in this topography are not uncommon. However, since synostosis is rare, this lesion was only described twice in the literature. We report two patients with a fracture of the single bone formed by a humeroradial synostosis and Bayne type-IV ulnar formation failure. Both patients were treated surgically with success. We emphasize the need for adequate treatment to not compromise the daily activities of patients who are adapted to their deformity, thus avoiding worsening the function of a previously affected limb.

Keywords

synostosis/surgery - radius/abnormalities - congenital abnormalities - syndrome - ulna/abnormalities.

^* Study developed at Hospital Santa Casa de Porto Alegre and Hospital Mãe de Deus, Porto Alegre, Brazil.

Publikationsverlauf

Eingereicht: 20. April 2020

Angenommen: 06. Juli 2020

Artikel online veröffentlicht:
18. Dezember 2020

• Referências

• 1 Kozin SH. Congenital differences about the elbow. Hand Clin 2009; 25 (02) 277-291
• 2 McCall AA, Kirsch CF, Ishiyama G, Ishiyama A. Otologic findings in Antley-Bixler syndrome: a clinical and radiologic case report. Int J Pediatr Otorhinolaryngol 2007; 71 (07) 1139-1143
• 3 Hosalkar HS, Shah HS, Gujar PS, Shaw BA. The Antley-Bixler syndrome: two new cases. J Postgrad Med 2001; 47 (04) 252-255
• 4 Tabrizi A, Afshar A, Aidenlou A. A case of failure to correct humerus-radius synostosis and thumb hypoplasia. J Hand Surg Eur Vol 2018; 43 (02) 211-213
• 5 McIntyre JD, Brooks A, Benson MK. Humeroradial synostosis and the multiple synostosis syndrome: case report. J Pediatr Orthop B 2003; 12 (03) 192-196
• 6 Nema S, Vyas G, Sirsikar A, Bhoj PK. Congenital humeroradial synostosis: a case report. Malays Orthop J 2012; 6 (SupplA): 41-42
• 7 Pfeiffer RA, Braun-Quentin C. Genetic nosology and counseling of humeroradial synostosis. Genet Couns 1994; 5 (03) 269-274
• 8 Miller JK, Wenner SM, Kruger LM. Ulnar deficiency. J Hand Surg Am 1986; 11 (06) 822-829
• 9 Swanson AB, Tada K, Yonenobu K. Ulnar ray deficiency: its various manifestations. J Hand Surg Am 1984; 9 (05) 658-664
• 10 Cole RJ, Manske PR. Classification of ulnar deficiency according to the thumb and first web. J Hand Surg Am 1997; 22 (03) 479-488
• 11 Card RY, Strachman J. Congenital ankylosis of the elbow. J Pediatr 1955; 46 (01) 81-85