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Mobilization of a Congenital Proximal Radioulnar Synostosis with Use of a Free Vascularized Fascio-Fat
Graft*†
by FUMINORI KANAYA, and KUNIO IBARAKI
J Bone Joint Surg AmVolume 80(8):1186-92
August 1, 1998
©1998 by The Journal of Bone and Joint Surgery, Inc.
Figs. 1-A, 1-B, and 1-C: Schematic drawings showing the operative procedure.
FUMINORI KANAYA, and KUNIO IBARAKI J Bone Joint Surg Am 1998;80:1186-92
©1998 by The Journal of Bone and Joint Surgery, Inc.
Fig. 1-B The radial head is reduced, and the distal fragment is supinated.
FUMINORI KANAYA, and KUNIO IBARAKI J Bone Joint Surg Am 1998;80:1186-92
©1998 by The Journal of Bone and Joint Surgery, Inc.
Fig. 1-C A vascularized fascio-fat graft is inserted in a volar-to-dorsal direction between the separated radius and ulna.
FUMINORI KANAYA, and KUNIO IBARAKI J Bone Joint Surg Am 1998;80:1186-92
©1998 by The Journal of Bone and Joint Surgery, Inc.
Figs. 2-A through 2-D: Photographs illustrating the intraoperative procedure.
FUMINORI KANAYA, and KUNIO IBARAKI J Bone Joint Surg Am 1998;80:1186-92
©1998 by The Journal of Bone and Joint Surgery, Inc.
Fig. 2-B After separation of the synostosis and the synchondrosis, the radial head (arrow) is trimmed and a trapezoid-shaped wedge of bone is resected to reduce the dislocated radial head.
FUMINORI KANAYA, and KUNIO IBARAKI J Bone Joint Surg Am 1998;80:1186-92
©1998 by The Journal of Bone and Joint Surgery, Inc.
Fig. 2-C The radius is fixed with a four-hole titanium plate.
FUMINORI KANAYA, and KUNIO IBARAKI J Bone Joint Surg Am 1998;80:1186-92
©1998 by The Journal of Bone and Joint Surgery, Inc.
Fig. 2-D The vascularized fascio-fat graft is shown along with a segment of skin obtained from the ipsilateral arm.
FUMINORI KANAYA, and KUNIO IBARAKI J Bone Joint Surg Am 1998;80:1186-92
©1998 by The Journal of Bone and Joint Surgery, Inc.
Figs. 3-A through 3-F: Case 7.
FUMINORI KANAYA, and KUNIO IBARAKI J Bone Joint Surg Am 1998;80:1186-92
©1998 by The Journal of Bone and Joint Surgery, Inc.
Fig. 3-B Lateral roentgenogram showing the posterior dislocation of the radial head.
FUMINORI KANAYA, and KUNIO IBARAKI J Bone Joint Surg Am 1998;80:1186-92
©1998 by The Journal of Bone and Joint Surgery, Inc.
Fig. 3-C Computerized tomographic scan showing the synostosis of the radius and ulna and a thin intervening septum.
FUMINORI KANAYA, and KUNIO IBARAKI J Bone Joint Surg Am 1998;80:1186-92
©1998 by The Journal of Bone and Joint Surgery, Inc.
Figs. 3-D, 3-E, and 3-F: Roentgenograms and computerized tomographic scans made two years and six months postoperatively.
FUMINORI KANAYA, and KUNIO IBARAKI J Bone Joint Surg Am 1998;80:1186-92
©1998 by The Journal of Bone and Joint Surgery, Inc.
Fig. 3-E Lateral roentgenogram showing reduction of the radial head.
FUMINORI KANAYA, and KUNIO IBARAKI J Bone Joint Surg Am 1998;80:1186-92
©1998 by The Journal of Bone and Joint Surgery, Inc.
Fig. 3-F Computerized tomographic scan showing separation of the synostosis.
FUMINORI KANAYA, and KUNIO IBARAKI J Bone Joint Surg Am 1998;80:1186-92
©1998 by The Journal of Bone and Joint Surgery, Inc.