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Radioulnar synostosis is a rare congenital condition characterized by an abnormal fusion of the radius and ulna, two bones in the forearm. This condition typically manifests at birth and can affect one or both arms, presenting various degrees of severity depending on the extent of the fusion. In a normal forearm, the radius and ulna are separate, allowing for a full range of motion, including pronation (turning the palm downwards) and supination (turning the palm upwards). However, in individuals with radioulnar synostosis, this rotational movement is significantly restricted, as the fused bones cannot move independently. The exact cause of radioulnar synostosis is not fully understood, but it is believed to arise from genetic and environmental factors during the early stages of fetal development. It can occur as an isolated condition or may be associated with other congenital syndromes, such as Holt-Oram syndrome, which affects the arms and heart. Clinical features of radioulnar synostosis include forearm deformities, such as a limited range of motion, wrist instability, and potential challenges in performing daily activities. Patients may exhibit difficulties in tasks requiring forearm rotation, such as turning a doorknob or using utensils, which can impact their quality of life and functional independence. Diagnosis typically involves a thorough physical examination and imaging studies, such as X-rays, to confirm the presence of the fusion and assess its extent. In many cases, radioulnar synostosis is diagnosed during infancy or early childhood when the limitations in forearm movement become more apparent. Treatment options vary based on the severity of the condition and the functional limitations experienced by the individual. In mild cases, physical therapy may be recommended to enhance strength and dexterity, focusing on improving overall function without surgical intervention. In more severe cases, surgical options may be considered to release the fused bones and restore some degree of movement. Surgical intervention can aim to re-establish the normal alignment of the radius and ulna, although outcomes can vary widely depending on individual circumstances. Furthermore, even after surgery, some patients may experience varying degrees of residual functional impairment or discomfort. Long-term management of radioulnar synostosis often requires a multidisciplinary approach, including orthopedic specialists, physical therapists, and occupational therapists, to optimize functional ability and support the patient in adapting to their condition. It's essential for individuals affected by radioulnar synostosis to receive appropriate counseling regarding their condition, as well as support for any associated psychosocial challenges that may arise due to the functional limitations imposed by the condition. Overall, radioulnar synostosis emphasizes the importance of early recognition and intervention to enhance the quality of life for those affected by this unique and complex congenital anomaly.