Radioulnar synostosis after the two-incision biceps repair: a standardized treatment protocol.

The purpose of this study was to evaluate the results of a 1-incision posterolateral surgical approach with concomitant irradiation (700 rad) for early resection of synostosis after a 2-incision biceps repair. Between 1992 and 2000, 8 patients with radioulnar synostosis after a 2-incision biceps repair were evaluated and treated, with a mean age of 38 years (range, 29-47 years). The mean time between tendon repair and resection of the synostosis was 7 months (range, 4-14 months). The mean follow-up was 27 months (range, 13-36 months). All patients had 0 degrees of forearm rotation preoperatively. Postoperatively, all patients underwent postoperative radiotherapy in two divided doses for a total of 700 cGy. At a mean follow-up of 27 months, the rotation arc of the forearm improved to 155 degrees (range, 140 degrees -170 degrees ). The strength of supination was 80% (range, 70%-90%) of the contralateral limb. Seven of the eight patients had no pain after activities of daily living or work. One had mild pain after prolonged activity. No radiographic or clinical evidence of synostosis recurrence was seen at final follow-up. We believe that resection of most radioulnar synostoses after 2-incision biceps repair can be achieved safely and efficaciously through one posterolateral incision.