Proximal radioulnar synostosis following Monteggia fracture-dislocation: a case report

Ann Med Surg (Lond). 2023 Oct 17;85(12):6218-6221. doi: 10.1097/MS9.0000000000001420. eCollection 2023 Dec.

Abstract

Introduction and importance: Radioulnar synostosis is a rare complication of a forearm fracture that restricts pronation-supination. This study presents a case of proximal radioulnar synostosis in an adult male after Monteggia fracture-dislocation who had a loss of pronation and supination movements.

Case presentation: Herein, we report a case of proximal radioulnar synostosis in a 43-year-old man who presented with loss of pronation and supination of the right forearm that restricted his daily activities. He had a history of Monteggia fracture-dislocation 9 months back, which was managed with open reduction and internal fixation with a dynamic compression plate. Plain radiography and computed tomography of the right forearm after 9 months of operation showed an implant in situ with proximal radioulnar synostosis. Implant removal was performed and the excess fibro-osseous connection in the proximal radius and ulna was removed.

Clinical discussion: Forearm injuries that affect the interosseous membrane may result in radioulnar synostosis. Trauma and treatment-related factors increase the risk of radioulnar synostosis. The fibro-osseous fusion between the forearm bones restricts the pronation and supination movements.

Conclusion: Loss of pronation-supination following forearm fracture should raise suspicion of radioulnar synostosis.

Keywords: Monteggia fracture; Nepal; case report; synostosis.

Publication types

  • Case Reports