OrthoNet

Synostosis
Complications - Synostosis

- rare and serious complication of forearm fractures or tibia fractures-
- must distinguish it from heterotopic bone

Forearm
- try to do both bones forearm ORIF through two incisions (but even then you can still see this problem)
- predisposing factors include:
- severe initial displacement
- residual displacement
- periosteal interposition
- delayed surgery
- re-manipulation
- fracture at the same level of the radius and ulna.

- treat with excision after waiting at least 1 year. Remove the bone and periosteum, lay in fat

Tibia
- there is some normal motion between the tibia and fibula at the ankle joint which gets obliterated with synostosis
- try to excise the synostosis, or resect part of the fibula and do screw fixation of the distal fibula to tibial epiphysis (kinda like a Sauve-Kapandji of the distal tibia)