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Surgical Treatment of Acute Elbow Flexion Contracture in Patients with Congenital Proximal Radioulnar SynostosisA Report of Two Cases
Tatsuya Masuko, MD1; Hiroyuki Kato, MD1; Akio Minami, MD1; Masayuki Inoue, MD2; Takakazu Hirayama, MD3
1 Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Kita-15, Nishi-7, Kita-Ku, Sapporo 060-8638, Japan. E-mail address for H. Kato: hirokato@hsp.md.shinshu-u.ac.jp
2 NTT East Japan Hospital, Minami-1, Nishi-15, Chuo-Ku, Sapporo 060-0061, Japan
3 Asahikawa Sekijuzi Hospital, Akebono-1/-1 Asahikawa 070-8530, Japan
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The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at the Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo, Japan

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2004 Jul 01;86(7):1528-1533
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Congenital proximal radioulnar synostosis is a rare congenital upper-extremity disorder in which the proximal aspects of the radius and ulna are fused and the rotational motion of the forearm is restricted. It has been estimated that 26% of all patients who have congenital radioulnar synostosis have a 10° to 30° limitation of elbow extension1. The Japanese-language literature includes reports on three patients with congenital proximal radioulnar synostosis who had an acute development of elbow flexion contracture2-4. However, to our knowledge, there have been no published reports in the English-language literature regarding patients with this disorder. We describe the cases of two boys with congenital proximal radioulnar synostosis in whom an elbow flexion contracture developed in a relatively acute manner. After removal of a hypoplastic lateral soft-tissue structure analogous to the annular ligament, both patients were able to achieve full extension of the elbow without recurrence of the elbow flexion contracture. Our patients and their families were informed that data from the cases would be submitted for publication.
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