Bilateral Proximal Radioulnar Synostosis-A Case Report

Synostosis or osseous union of any 2 adjacent bones can involve any part of the body. Synostosis between radius and ulna can take two forms, congenital and post-traumatic. Proximal Radioulnar Synostosis is a very rare congenital anomaly and most cases are sporadic, congenital and less often post-traumatic, bilateral in 60% and more common in males. It is often part of syndromes such as Crouzon, Apert's and Poland's,4p- syndrome, Williams syndrome, acrofacial dysostosis, Antley- Bixler syndrome, Genito- patellar syndrome, Greig Cephalo- polysyndactyly syndrome, hereditary multiple osteochondromas (hereditary multiple exostoses), limb-body wall complex, and Nievergelt syndrome. Although the exact etiology is not clear, it has been documented that there is a genetic basis for the failure of differentiation between the radius and ulna. We came across such rare specimen of bilateral proximal radioulnar synostosis in Department of Anatomy, Sri Devaraj Urs Medical College, Kolar, Karnataka.The specimen was incidentally obtained from disarticulated upper limbs of a male cadaver aged 70yrs which were buried under the soil to obtain bones for study purpose. The procured bone specimen of proximal radioulnar synostosis was cleaned and later relevant segmental measurements were taken.The rarity of this condition often leads to the delayed clinical diagnosis. The rationale for surgery is dictated more by individual functional limitations rather than on absolute forearm position.