[Differential diagnosis and therapy of post-traumatic limited forearm rotation]

Limited forearm rotation is an extremely disabling condition for patients. For forearm function, simultaneous rotation in the proximal and distal radioulnar joint is necessary, being connected by the radius and ulnar shaft. Any malalignment of these bony components as well as injuries to the stabilizing soft tissues will lead to an impaired function of the forearm joint. The combination of bony malalignment and joint instability is possible and must be recognized. Any chronic incongruency of the joints will lead to secondary arthrosis that allows only salvage procedures. Therefore, the underlying pathology of restricted forearm motion must be recognized and the original anatomy restored. Using clinical examples, the possible posttraumatic reasons for disturbed forearm rotation and the principle of anatomical reconstruction are presented.