Osteotomy of the Proximal End of the Radius for Paralytic Supination Deformity in Children

Abstract

1. Open osteotomy near the tuberosity of the radius to enable correction of fixed supination deformity of the forearm in children is an alternative to Blount's closed osteoclasis of both bones. 2. In five out of six cases with residual obstetrical palsy substantial correction of the deformity was maintained. 3. The cosmetic result was impressive, especially in girls, but an improved function was also observed. If the hand is paralysed, correction of supination facilitates reconstruction. 4. Complications such as angulation, displacement, delayed union and synostosis of the proximal radius and ulna did not affect the final results. 5. With the method described a more or less permanent "blocking" of rotatory movement in the forearm was observed but this did not seem to impair the functional result.

Z-Plastik und Umleitung der Bizepssehne mit Release der Membrana interossea zur Wiederherstellung der Pronation bei lähmungsbedingten Supinationsfehlhaltungen und -kontrakturen

“…Klinisch kann das Ausmaß der Supinationsfehlhaltung/-kontraktur nach Zancolli et al [18] Für die Therapie der Supinationsfehlhaltung/-kon traktur stehen neben dem Release der Membrana inter ossea [12] Sehnenverlagerungen [5,10,13,14,17], Osteoklasien [2] und Osteotomien [6,7,20] In Gruppe I erfolgt eine Umleitung der Bizepssehne (bei guter Trizepsfunktion) oder ein Transfer der Sehne des Musculus flexor carpi ulnaris auf den Ansatz der Sehne des Musculus brachioradialis (bei schlechter Trizepsfunktion).…”

“…Nach Zancolli & Zancolli [19] kommt es durch die Fusion im weiteren Wachstum zu keiner Beeinträchtigung. Osteoklasien [2] und Osteotomien [20] zur Korrektur der knöcher-nen Fehlstellung sollten erst nach Abschluss des Wachstums durchgeführt werden, da ansonsten ein hohes Risiko für das Auftreten eines Rezidivs besteht [10,18].…”

Perceived outcomes and utilization of upper extremity surgical reconstruction in individuals with tetraplegia at model spinal cord injury systems

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] In addition, there are procedures to reduce contractures such as the rotational radial osteotomy to correct a forearm supination contracture or a biceps tendon lengthening to reduce elbow flexion contractures. [16][17][18][19][20][21] Tendon transfer procedures have traditionally been most effective for individuals who have sustained injuries at the C5-C7 level, as persons at this level have strong but redundant donor muscles to be used for providing additional function. Tendon transfer options for persons injured at the C4 level are limited due to the lack of voluntary muscles.…”

Corrective Osteotomies of the Radius and Ulna for Supination Contracture of the Pediatric and Adolescent Forearm Secondary to Neurologic Injury

“…[1][2][3][4][5][6][7][8][9][10][11] A soft-tissue technique can be used to correct a supple or fixed supination deformity. Steindler 1 described simple sectioning of the supinator muscle; Zancolli 7 recommended release of the interosseous membrane combined with rerouting of the We report a consecutive series of patients in whom a proximal ulna osteotomy combined with a distal radius osteotomy was performed to correct a fixed supination deformity in pediatric and adolescent forearms.…”