Congenital Radio-Ulnar Synostosis

This chapter details a case study of a 12-year-old right hand–dominant female who was presented with difficulties using her lefthand especially when two-handed activities were involved. This problem had been present since early childhood but had become more noticeable in adolescence owing to the changing nature of activities and her increasing need for independence. Examination of the right arm and hand was normal. Any passive attempt to supinate the forearm produced some movement at the radio-carpal joint but not between the forearm bones. Forearm x-rays and CT scans confirmed the presence of a proximal radio-ulnar synostosis. A position of 20 degrees pronation from the neutral position would allow continued prone hand activities and, with some shoulder and elbow position adaptation, a neutral hand position to be of greater use in coordinated two-handed activities. Physiotherapy was commenced at six weeks after some signs of early bone healing were visible on x-ray.