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29S Congenital Kirschner wire. Collateral ligaments were also reconstructed. Results: Age at operation was 1.5 years on average. The proximal phalanx of the fourth toe was used in 51 and that of the third toe in 3. Seven toes were trimmed because the skin pocket was tight. Silastic expander was used for tissue expansion before toe phalanx transfer in 4 cases. Five cases required revision surgery for partial necrosis of the skin pocket. Five children (7 toes) were lost before 5-year follow-up, and hence excluded for evaluation. Six children underwent bone lengthening procedure between 5- and 10-year follow-up period, and 10 children did not reach 10 years after surgery. They, too, were excluded for the evaluation at 10-year follow-up. At 5-year follow-up, the physis was closed in 30%, growth rate was 0.8 mm/year, and %length was 87%. At 10-year followup, closure rate increased to 85%, growth rate decreased to 0.5 mm/year, and %length was 69%. Conclusion: Free nonvascularized toe phalanx transfer is a versatile procedure for reconstruction of the congenital finger deficit. Growth ability remains at least 5 years in most of the cases but it decreases when they reached 10-year follow-up period. Evaluation of Postoperative Radiocapitellar Joint Alignment in Congenital Radioulnar Synostosis Patients Kazuki Kuniyoshil, Tomoyo Akasakal, Takane Suzuki2, Yusuke Matsuural, Rei Abel, Keisuke Uenol, Hitoshi Kiuchil, Aya Kanadukal, Naoya Hirosawal, Maki Iwasel, and Atsuro Yamazakil 1 Department of Orthopedic Surgery, Graduate school of Medicine, Chiba University, Japan 2 Department of Environmental Medicine, Graduate school of Medicine, Chiba University, Japan Hypothesis: No study has evaluated radiocapitellar joint alignment or proximal radioulnar joint alignment postoperatively in congenital radioulnar synostosis patients. The aim of this study was to clarify the postoperative clinical results and radiocapitellar joint alignment. Methods: Eight forearms in 7 patients (6 males and 1 female with a mean age of 8.8 years) with congenital radioulnar synostosis, who underwent surgery with a minimum of a year and a mean of 2.1 years of follow-up, were evaluated. The surgery consisted of division of the synostosis and interposition with a pedicled vascularized adipofascial flap between the radius and the ulna. A corrective radial osteotomy was performed in 3 patients at the radial neck, which had a great angular deformity, and in 1 patient at the mid-diaphysis, which had a great bowing deformity. Radiocapitellar joint alignment was evaluated in a lateral view radiograph and classified into 3 types as anterior, intermediate, or posterior, defined by whether the radial neck and head axis were above, within, or below the capitellum. This alignment was evaluated preoperatively and at final follow-up. The active range of prono-supination was also evaluated as a clinical outcome. There was no patient who had recurrence of bony union at the divided synostosis. Results: Preoperatively, there were 5 forearms of the anterior type, 1 intermediate type, and 2 of the posterior type. At final follow-up, there were 2 forearms of the anterior type and 6 of the posterior type. Four forearms were changed into a posterior type. At the final follow-up, the active range was 37.5 ± 8° in pronation and 20 ± 10° in supination in the anterior type, and was 41 ± 23° in pronation and 26 ± l8° in supination in the posterior type. There was no significant difference in pronation or supination between types. It was more difficult to improve supination than pronation in each type. Summary points: In this case series, it was difficult to reconstruct the proper radiocapitellar alignment. To better improve the range, especially of supination, reconstruction of the radiocapitellar joint or the proximal radioulnar joint with a more accurate corrective radial osteotomy or sigmoid notch plasty should be considered. Congenital Flexion Deformity of the Long, Ring, and Little Fingers With an Aberrant Origin of the Flexor Digitorum Profundus: Differential Diagnosis With the Volkmann’s Contracture Ge Xiong1 1 Beijing Jishuitan Hospital, China Objective: To report a series of cases of congenital flexion deformity of the long, ring, and little fingers with an aberrant origin of the flexor digitorum profundus and to compare this disease with the Volkmann’s contracture. Materials and Methods: Five cases of congenital flexion deformity of the long, ring, and little fingers with an aberrant origin of the flexor digitorum profundus were reported. Two of them were children. All the patients were misdiagnosed as the Volkmann’s contracture in the local clinics. Radiographs and 3-D computed tomography (3-D CT) of the involved forearm were performed. There were no neural disorders in any case. Results: The 3-D CT showed there was a bone prominence on the proximal part of the ulna. During the operation, we could find an aberrant origin of the flexor digitorum profundus of 3 to 5 fingers was attached to the bone prominence. Resection of the aberrant origin could achieve a thorough release in children cases but further muscle sliding procedure was needed in adult cases. Conclusion: Congenital flexion deformity of the long, ring, and little fingers with an aberrant origin of the flexor digitorum profundus is a potentially ignored disease. Finding the bone prominence on the proximal part of the ulna is helpful for the early diagnosis. Resection of the aberrant origin with muscle sliding procedure can get good result.