Clinical and radiological aspects of the forearm in children with congenital radioulnar synostosis: a cohort study

Introduction The upper limb functional limitations in congenital radioulnar synostosis may significantly affect the daily activities of patients. Classifications of the condition are descriptive and have limited practical application.Purpose Determine a functionally significant quantitative criterion for anatomical changes in the forearm.Material and methods 92 children (136 forearms) with congenital radioulnar synostosis were examined for limitations in activities of daily living (ADL), health-related quality of life measured with PedsQL questionnaire; pronation of the forearm and radiographic parameters. A comparative and correlation analysis, ROC analysis were performed to determine the relationship between the forearm pronation and limitations of ADL.Results Statistically significant correlations were revealed between symptoms and the forearm alignment (p xy = 0.5); subluxation of the ulnar head and forearm alignment (p xy = 0.6); bowing deformity of the radius, forearm alignment and subluxation of the ulnar head and between the length of the forearm bones and bowing deformity of the radius (p xy = 0.4 and rxy = 0.5). A statistically significant inverse correlation was revealed between symptoms and PedsQL scores (p = 0.038, rxy = -0.4). Pronation of 45° was the threshold value of the forearm alignment with a high risk of ADL limitation. The area under the ROC curve corresponding to the relationship between symptoms and the forearm alignment was 0.955 ± 0.021 (95 % CI: 0.915-0.995). There was a statistically significant (p function show_eabstract() { $('#eabstract1').hide(); $('#eabstract2').show(); $('#eabstract_expand').hide(); }