A comparison of proximal radioulnar synostosis excision after trauma and distal biceps reattachment.

We tested the hypothesis that the results of operative resection of a proximal radioulnar synostosis are better when the synostosis is due to a distal biceps reattachment (11 patients) than when it occurs after trauma (13 patients). Two patients in the trauma cohort had recurrence of the synostosis, and 1 had repeat resection. Two patients in the trauma cohort and 1 in the biceps cohort had substantial loss of forearm rotation due to regrowth of heterotopic ossification without synostosis, and 2 patients were addressed with subsequent surgeries. The arc of forearm rotation after the index surgery averaged 94 degrees in the trauma cohort and 131 degrees in the biceps cohort. This study confirms that operative resection of a proximal radioulnar synostosis can restore substantial motion in most patients. The results for excision of a synostosis after a distal biceps reattachment were better than those of excision of a synostosis after trauma.