Management of an Ulnar Nonunion in a Pediatric Case with Rothmund-Thompson Syndrome

Introduction: Rothmund-Thomson syndrome (RTS) is a rare autosomal recessive genodermatosis characterized by poikiloderma, short stature, juvenile cataracts, sparse hair, skeletal abnormalities, and a predisposition to osteogenic sarcomas and skin cancers. While numerous skeletal abnormalities have been described in patients with Rothmund-Thomson syndrome, nonunion cases are rarely reported in the literature. Case report: In this study, we present the case of a patient with RTS who sustained a combined ulna and radius fracture in the proximal forearm after a simple fall. The patient was followed for four months with titanium elastic nails, but despite union of the radius, nonunion of the ulna was observed. A second trauma later resulted in re-displacement of the old fracture line of the ulna. The patient subsequently underwent stable fixation with plate and screw fixation, received additional medical treatment, and union was achieved. Conclusion: With our report, we hope to increase practitioner awareness that delayed bone healing may be a possibility in RTS patients and to encourage consideration of routine imaging and calcium and vitamin D supplementation.