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Case: A 57-years old man who sustained left distal radius fracture. We performed distal radius ORIF. At follow up visit, he could not achieve any supination-pronation movements. Radiographs showed radioulnar synostosis. Four months later, we performed excision of synostosis with interposition of fat graft in the left forearm. A year later, the patient showed good forearm pronation and supination. Conclusion: This a rare case of radioulnar synostosis after ORIF distal radius fracture. Surgical intervention will help to improve the outcomes.