Congenital radius-ulna fusion

　　This malformation is dominant in some patients, with the radius and ulna originating from mesodermal tissue during embryonic development. When the embryo is in the fifth week, the radius and ulna cartilage rods do not separate and ossify, or mesodermal tissue fills the space between the radius and ulna, resulting in radius-ulna fusion. Type II radial head dislocation occurs in the late fetal stage.

　　What diseases can congenital radius-ulna fusion be associated with:

　　This disease mainly produces some postoperative complications, so early observation should be rigorous after surgery, and attention should be paid to the appearance of ischemic changes in the affected limb. Elevate the limb, and use a moderate amount of diuretics if necessary. For those who have developed vascular crises, it is important to open and decompress in time to save the limb and ensure its function. If complications occur and are not treated in a timely manner, ischemic muscle contracture and necrosis may occur. In addition, attention should also be paid to the fact that due to the strong tolerance of children to pain and their innate restlessness, the new bone callus is continuously destroyed, leading to the fracture of internal fixation. Therefore, it is advisable to strengthen postoperative protection and use a plaster cast for one month if necessary, in order to achieve stage I healing and obtain satisfactory function.

　　There is no active movement between the radius and ulna, the forearm is fixed in the pronated position, the supinated function is lost, the extension movement of the elbow joint is partially restricted, and the wrist joint can move freely. The degree of impact on daily life is related to the fixed malformation of the forearm, such as in unilateral involvement, the functional impact is small. The forearm of the affected limb is relatively thin and curved in shape. Due to incomplete development of the radial head or anterior and posterior dislocation, a local depression can be seen on the normal radial head. This malformation is generally divided into three types: Type I is true congenital radius-ulna fusion, where the upper ends of the radius and ulna fuse together without cortical bone, and the radial head fuses with the ulna or is completely absent. The latter often affects both sides, with the radius bending, thicker, and longer than the ulna. Fusion generally does not occur between the distal ends of the radius and ulna, Type II is... Type III is where the radius and ulna are connected by an interosseous ligament, which hinders the rotation function of the forearm. This type is not a true fusion, but the clinical manifestations are consistent.

　　How to prevent congenital radius-ulna fusion:

　　This disease is a congenital condition with no effective preventive measures. Early diagnosis and treatment are the key to preventing and treating the disease. Parents should pay close attention to their children's daily activities and take their children to a regular hospital for a consultation promptly if they find any abnormal movements or dysfunction of the forearm rotation, in order to prevent the delay of the disease.

　　The examination of this disease is mainly divided into two types:

　　1. Physical examination:There is no active movement between the radius and ulna, the forearm is fixed in the pronated position, the supination function is lost, the extension movement of the elbow joint is partially restricted, and the wrist joint can move freely.

　　2. X-ray photography:The upper ends of the radius and ulna fuse together, with no cortical bone in between; the radial head fuses with the ulna or the radial head is completely absent; or the radial head is posteriorly dislocated and fused with the upper part of the ulna shaft.

　　What is good to eat for congenital fusion of the radius and ulna? According to different symptoms, there are different dietary requirements. It is recommended to consult a doctor for specific dietary standards tailored to the patient's specific condition.

　　Precautions before treatment for congenital fusion of the radius and ulna:

　　1. The degree of deformity of each patient should be truly assessed to determine whether surgical treatment is needed. Generally, it is not recommended to separate the fusion site of the radius and ulna, because the efficacy is often very poor. If the deformity of the pronation of the forearm is severe and exceeds 60°, a rotational osteotomy at the proximal one-third of the radius and ulna can be performed to keep the forearm in a functional position. Generally, the Kelikian rotation technique can obtain a certain range of rotation activity of the forearm. The method is to remove the distal part of the ulna shaft and relocate the ulnar flexor carpi ulnaris tendon to restore the supination function, but the efficacy is sometimes uncertain.

　　The main symptoms of congenital fusion of the upper radius and ulna are dysfunction of forearm rotation. Forearm rotation is a relatively complex movement. When the ulna is fixed, the forearm rotation axis is from the center of the radial head to the attachment of the ulna to the deltoid ligament. Along this axis, at the superior radioulnar joint, the radial head rotates around the radial notch of the ulna. The normal pronation of the forearm is about 80 degrees, and the supination is about 100 degrees. When the pronation or supination is reduced by no more than 30 degrees, the rotation function will not affect the patient's work and life.