Corrective Osteotomies and Osteosynthesis for Supination Contracture of the Forearm in Children

Rolfe, Kevin W.; Green, Terri A.; Lawrence, John F.

doi:10.1097/bpo.0b013e3181a6bf90

Cited by 11 publications

(3 citation statements)

References 7 publications

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“…On the other hand, Rolfe et al studied 14 patients who underwent distal ulnar osteotomy without fixation and subsequent midradial osteotomy with plate fixation. They found a final mean position of pronation of 24° at six months [ 18 ]. The intraoperative goal of achieving 30–40° of pronation was determined by a preoperative clinical examination and a dedicated occupational therapist, in addition to the extent of functional impairment caused by the deformity, which prevented the patients from resuming their daily activities.…”

Section: Discussionmentioning

confidence: 99%

“…Zaoussis preferred osteotomy of the radial neck with internal fixation [ 10 ]. Gilbert implemented a strategy to approach these patients depending on the clinical picture, whether it was a fixed or flexible deformity, and whether the radial head was dislocated [ 4 , 5 , 7 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…The deformity is flexible and passively pronated at an early stage (less than two years). However, with time, it tends to progress to a fixed deformity due to the contraction of the interosseous membrane, the short biceps brachii, and supinator muscles [4]. The deformity may progress, causing subluxation and dislocation of the distal radioulnar joint, radial head, or radial curvature [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Clinical and psychosocial outcomes following correction of supination deformity in obstetrical brachial plexus palsy patients: A retrospective study

Hamdi

Doubi

Abalkhail

et al. 2022

BMC Musculoskelet Disord

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Background Forearm supination contracture is the mostAQ common deformity of the forearm following obstetric brachial plexus palsy (OBPP). Supination deformities in OBPP may be corrected by performing forearm osteotomy; however, the high recurrence rate limits patient satisfaction. Apart from the cosmetic impairment of this deformity, there are no previous reports on the clinical and psychosocial outcomes of forearm osteotomy in patients with supination deformities secondary to OBPP. Therefore, our study aimed to assess the clinical, functional, and psychosocial outcomes following forearm pronation osteotomy in OBPP patients with supination deformity. Methods This retrospective study was conducted after a chart review of all OBPP sequelae with supination forearm deformity in patients who underwent forearm pronating osteotomy from 2006 to 2018. Data relating to OBPP were gathered, and functional and psychosocial outcomes were assessed using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire through interviews Results This study included 60 patients with a mean age of 8.7 years at the time of surgery. A total of 46 patients had lesions involving C5-T1 (76.7%). The mean preoperative supination deformity position was 68.5°, the mean amount of correction was 98.9°, and the mean forearm position was 30.5°, postoperatively. In the DASH assessment scale used postoperatively, 24 patients (42.9%) reported no restrictions on their daily activities, 25 patients (44.6%) believed that their social activities were unaffected, and 20 patients (35.7%) strongly disagreed with feeling less capable or less confident due to arm, shoulder, or hand problems. The factors significantly affecting position at the final follow-up were the amount of correction (p = 0.011), postoperative position (p = 0.005), and degree of pronation achieved (p = 0.02). The amount of correction significantly affected both self-confidence (p = 0.049) and activities of daily living (p = 0.033). Conclusion In conclusion, our study showed that the position at the final follow-up, the degree of pronation achieved intraoperatively, and the postoperative position significantly affected the position at follow-up and the outcome assessment. The amount of intraoperative correction was significantly associated with higher self-confidence and normal activities of daily living.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical and psychosocial outcomes following correction of supination deformity in obstetrical brachial plexus palsy patients: A retrospective study

Hamdi

Doubi

Abalkhail

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

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Neurological Disorders: Elbow and Forearm Contractures

Celli

2022

Atlas of Elbow Surgery

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Posttraumatische Torsionsfehler am Unterarm

2018

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Forearm fractures are common in all age groups. Even if the adjacent joints are not directly involved, these fractures have an intra-articular character. One of the most common complications of these injuries is a painful limitation of the range of motion and especially of pronation and supination. This is often due to an underdiagnosed torsional deformity; however, in recent years new methods have been developed to make these torsional differences visible and quantifiable through the use of sectional imaging. The principle of measurement corresponds to that of the torsion measurement of the lower limbs. Computed tomography (CT) or magnetic resonance imaging (MRI) scans are created at defined heights. By searching for certain landmarks, torsional angles are measured in relation to a defined reference line. A new alternative is the use of 3D reformation models. The presence of a torsional deformity, especial of the radius, leads to an impairment of the pronation and supination of the forearm. In the presence of torsional deformities, radiological measurements can help to decide if an operation is needed or not. Unlike the lower limbs, there are still no uniform cut-off values as to when a correction is indicated. Decisions must be made together with the patient by taking the clinical and radiological results into account.

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Corrective Osteotomies and Osteosynthesis for Supination Contracture of the Forearm in Children

Abstract: Level IV.

Cited by 11 publications

References 7 publications

Clinical and psychosocial outcomes following correction of supination deformity in obstetrical brachial plexus palsy patients: A retrospective study

Clinical and psychosocial outcomes following correction of supination deformity in obstetrical brachial plexus palsy patients: A retrospective study

Neurological Disorders: Elbow and Forearm Contractures

Posttraumatische Torsionsfehler am Unterarm

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