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Case Reports in Orthopedics
Volume 2017, Article ID 3271026, 4 pages
Case Report

The Dorsoulnar Artery Perforator Adipofascial Flap in the Treatment of Distal Radioulnar Synostosis

1Hand and Microsurgery Unit, Jewish Hospital, Rome, Italy
2Department of Orthopaedics and Traumatology, Padre Pio Hospital, Bracciano and San Paolo Hospital, Civitavecchia, Italy

Correspondence should be addressed to Giorgio Antonietti; moc.liamg@oigroig.itteinotna

Received 21 February 2017; Accepted 21 June 2017; Published 24 July 2017

Academic Editor: Johannes Mayr

Copyright © 2017 Alessia Pagnotta et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Posttraumatic radioulnar synostosis (RUS) is a rare event following forearm fractures. Consequences are disabling for patients who suffer from functional limitation in forearm pronosupination. Distal RUS are even more rare and more difficult to treat because of high recurrence rates. The patient we describe in this paper came to our attention with a double distal RUS recurrence and a Darrach procedure already performed. We performed a radical excision of RUS and interposition with a vascularized dorsoulnar artery (DUA) adipofascial perforator flap. Four years after surgery, the patient shows the same complete range of motion in pronosupination, and MRI confirms that the flap is still in place with signs of vascularization. Simple synostosis excision has been proven ineffective in many cases. Interposition is recommended after excision, and biological material interposition seems to be more effective than foreign material. Surgeons are increasingly performing vascularized interposition, and the results are very encouraging.