Radioulnar Synostosis | Diagnosis & Treatments

 

How Boston Children's Hospital diagnoses radioulnar synostosis

At Boston Children's Hospital, we understand that the first step to treating your child is obtaining an accurate, timely, and thorough diagnosis.

Your child’s doctor will do a thorough medical history and careful physical exam. X-rays and/or CT scans may be used to confirm the diagnosis, assess the underlying structure of the baby’s deformity, check for related conditions, and determine a course of treatment.

In milder cases, radioulnar synostosis may not be noticeable and doctors may diagnose it during a child’s later school age years or adolescence, since the child rarely experiences pain, and some children don’t experience too much functional limitation of the limited forearm movement. In fact, your child may notice only subtle differences in her ability to rotate her forearm.

In more serious cases, a child’s forearm rotation is much more limited and obvious, so the diagnosis can be made at an earlier age — typically around age 6.

Our Orthopedic Clinical Effectiveness Research Center (CERC)

Boston Children’s Orthopedic Clinical Effectiveness Research Center (CERC) was established by our Orthopedic Center to improve the quality of life for children with musculoskeletal disorders. This collaborative clinical research program is unique in the nation and is playing an instrumental role in establishing, for the first time, evidence-based standards of care for pediatric orthopedic patients throughout the world.

Boston Children’s Hand and Reconstructive Microsurgery Program

The doctors and staff in the Hand and Reconstructive Microsurgery Program at Boston Children's Hospital are recognized experts in the management of congenital and acquired hand deformities.

How Boston Children’s treats radioulnar synostosis

At Boston Children's Hospital, our Orthopedic Center's Hand and Orthopedic Upper Extremity Program provides comprehensive care — including evaluation, diagnosis, consultation, surgery, non-surgical therapies, and follow-up care.

In general, your child's doctor will determine treatment based on whether your child is having problems using her arm, rather than the absolute position of the forearm.

Some children's forearms lie in functional positions, and never need surgery. Children who have the problem in both arms, and/or in whom the forearm is fixed in a position that limits their ability to use their arm, may benefit from surgery, preferably before they reach school age.

Surgery

Surgery can be performed either to remove the abnormal soft tissue or bony connection or to position the forearm in a more functionally acceptable position.

While it's rare that surgery can reconstruct a “normal” joint between the radius and ulna, some children see significant improvement in function from osteotomy (bone-cutting) procedures, in which the forearm bones are surgically repositioned.

Coping and support

At Boston Children's Hospital, we understand that a hospital visit can be difficult, and sometimes overwhelming. So, we offer many amenities to make your child's — and your own — hospital experience as pleasant as possible. Visit the Hale Family Center for Families for all you need to know about:

In particular, we understand that you may have a lot of questions when your child is diagnosed with radioulnar synostosis. Will this affect my child long term? Will she be able to enjoy regular activities? We can connect you with extensive resources to help you and your family through this stressful time, including:

  • patient education: From doctor's appointments to physical therapy and recovery, our nurses and physical therapists will be on hand to walk you through your child's treatment and help answer any questions you may have — Why will my child need surgery? Are there non-surgical options? How long will her recovery take? How should we manage home exercises and physical therapy? We'll help you coordinate and continue the care and support your child received while at Children's.
  • parent-to-parent: Want to talk with someone whose child has been treated for radioulnar synostosis? We can often put you in touch with other families who've been through the same process that you and your child are facing, and who will share their experiences.
  • faith-based support: If you're in need of spiritual support, we'll connect you with the Boston Children's chaplaincy. Our program includes nearly a dozen clergy — representing Protestant, Jewish, Muslim, Roman Catholic, and other faith traditions — who will listen to you, pray with you, and help you observe your own faith practices during your hospital experience.
  • social work: Our social workers and mental health clinicians have helped many families in your situation. We can offer counseling and assistance with issues such as coping with your child's diagnosis, stresses relating to coping with illness, and dealing with financial difficulties.