One-bone forearm fusion for pediatric supination contracture due to neurologic deficit

The purpose of this study was to review the construction of a one-bone forearm performed to change the position of the forearm in children with fixed supination deformity due to upper extremity neurologic deficit. The one-bone forearm arthrodesis has been previously described in treating trauma, tumors, infection, and congenital deformities. It has not been described to improve forearm position in neurologically impaired upper extremities. We retrospectively evaluated 6 pediatric patients with upper extremity weakness and severe supination contracture who underwent forearm arthrodesis in neutral or slight pronation. Five patients achieved fusion, and 1 patient had an atrophic nonunion (17% nonunion rate). Average follow-up was 6 years 6 months (range 1 year 9 months to 11 years 2 months), and all patients were satisfied with their new forearm position.