Selection of fusion position during forearm arthrodesis

The purpose of this study was to determine the optimal position for forearm arthrodesis. We attempted to determine functional difficulties associated with different positions of simulated fusion and whether there was a difference between men and women in their preference for fusion position. The forearms of 30 subjects were immobilized in neutral, 45 degrees supination, and 45 degrees pronation. The subjects performed 2 functional tests in each splint: the Jebsen hand function test and a subjective evaluation of the difficulty of activities of daily living. Each subject was asked to choose a preferred position for forearm fusion. Overall, subjects found the supinated position the most difficult to adapt to; the majority (63.3%) preferred neutral. Based on the results of our study we recommend forearm fusion in neutral or slight pronation. A thorough preoperative activity history and functional assessment may assist in determining the desired forearm arthrodesis position in a given individual.