Complications – Synostosis

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

– 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

– 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)

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