Creation of elbow joint in children with humeroradial synostosis. A clinical case

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Abstract

Humeroradial synostosis is a severe rare anomaly of the upper limb, leading to the development of disability. This congenital anomaly may be a separate nosological unit, or a part of a genetic syndrome. Multi-stage surgical treatment is correct for all components of the deformity. The most difficult stage of treatment is the creation of an elbow joint. There are few studies on this problem in the literature. The article presents the results of surgical treatment of two children with humeroradial synostosis, who had the elbow joint created using two techniques. Patient A. underwent microsurgical transplantation of 2–3 metatarsophalangeal joints into the area of the elbow joint that had been absent since birth. Patient B. underwent total arthroplasty of the elbow joint with an individual implant. The unsatisfactory result of the treatment of patient A. is associated with the impossibility of early development of movements in the elbow joint due to the presence of axial pins. The stable position of the endoprosthesis in patient B. made it possible to conduct a course of early development of movements and get a good long-term result. Due to small number of patients, it is impossible to reliably assess the advantage of one of the presented methods. Improvement of the results of treatment in children with humeroradial synostosis requires further research.

About the authors

D. Yu. Grankin

H. Turner National Medical Research Center for Children’s Trauma Surgery and Orthopedics

Author for correspondence.
Email: grankin.md@gmail.com
ORCID iD: 0000-0001-8948-9225
SPIN-code: 1940-3837

Researcher, Department of Reconstructive Microsurgery and Hand Surgery

Russian Federation, Saint-Petersburg

S. I. Golyana

H. Turner National Medical Research Center for Children’s Trauma Surgery and Orthopedics

Email: ser.golyana@yandex.ru
ORCID iD: 0000-0003-1319-8979
SPIN-code: 8360-8078

Candidate of Medical Sciences, Scientific Supervisor, Department of Reconstructive Microsurgery and Hand Surgery

Russian Federation, Saint-Petersburg

N. V. Avdeychik

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: natali_avdeichik@mail.ru
ORCID iD: 0000-0001-7837-4676
SPIN-code: 6059-4464

Orthopedic Surgeon

Russian Federation, Saint-Petersburg

A. V. Safonov

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: safo125@gmail.com
ORCID iD: 0000-0003-1923-7289

Candidate of Medical Sciences, Head of the Department of Reconstructive Microsurgery and Hand Surgery

Russian Federation, Saint-Petersburg

A. I. Arakelyan

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: a_bryanskaya@mail.ru
ORCID iD: 0000-0002-3998-4954
SPIN-code: 9224-5488

Candidate of Medical Sciences, researcher, Department of Consequences of Injuries and Rheumatoid Arthritis

Russian Federation, Saint-Petersburg

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Patient A. : a - appearance of the upper limb before microsurgical autografting of the 2-3rd PFS block to the position of the right elbow joint; b - radiograph of the upper limb before microsurgical autografting of the 2-3rd PFS block to the position of the right elbow joint; c - stage of surgical intervention - autograft of the 2-3rd PFC block was isolated; d - radiograph of the upper limb after microsurgical autografting of the 2-3rd PFC block to the position of the right elbow joint

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3. Fig. 2. Control radiograph of the upper extremity 4 months after surgical treatment

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4. Fig. 3. Patient B: a - radiograph of the upper extremity before elbow joint endoprosthesis; b, c - appearance of the upper extremity after installation of an individual elbow joint endoprosthesis; d, e - radiographs of the upper extremity after installation of an individual elbow joint endoprosthesis

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5. Fig. 4. Patient B. 2 years after installation of a customized elbow endoprosthesis: a, b - appearance of the upper extremity; c, d - radiographs of the upper extremity

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