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A surgical technique for pediatric forearm pronation: brachioradialis rerouting with interosseous membrane release
Turker Ozkan1, Atakan Aydin, Kagan Ozer
1Istanbul University Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Hand Surgery Division, D:5, Nisantasi, Istanbul, Turkey.
Insights
Brachioradialis rerouting with interosseous membrane release effectively restored forearm pronation in children with brachial plexus birth palsy. This surgical technique improved active rotation and corrected supination deformities.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Reconstructive Surgery
Background:
- Brachial plexus birth palsy often results in supination deformity of the forearm.
- Restoring active forearm pronation is crucial for functional recovery in affected children.
Purpose of the Study:
- To evaluate the efficacy of brachioradialis rerouting with interosseous membrane release for correcting supination deformity.
- To assess the functional improvement in active forearm pronation following this surgical intervention.
Main Methods:
- A tendon transfer technique involving brachioradialis rerouting and interosseous membrane release was performed.
- The procedure was applied to four pediatric patients aged 5–9 years with supination deformities secondary to brachial plexus birth palsy.
Main Results:
- Mean active forearm rotation improved significantly from 28 degrees supination to 49 degrees pronation post-surgery.
- No elbow contractures were observed during a minimum follow-up period of 12 months.
Conclusions:
- Brachioradialis rerouting combined with interosseous membrane release appears to be a successful surgical option.
- This technique offers a viable solution for correcting forearm supination deformities in pediatric brachial plexus palsy.
Purpose:
In this study we used a tendon transfer technique (consisting of rerouting of the brachioradialis with interosseous membrane release) to restore active forearm pronation in patients with supination deformity secondary to brachial plexus birth palsy.
Methods:
Four children (3 with flexible supination deformities, 1 with a fixed supination deformity) whose ages ranged between 5 and 9 years had brachioradialis rerouting with interosseous membrane release.
Results:
Mean active forearm rotation was improved from 28 degrees supination before surgery to 49 degrees pronation after surgery. No patient developed elbow contracture during a minimum of 12 months of follow-up evaluation (40 months in 2 patients, 14 months in 1 patient, 12 months in 1 patient).
Conclusions:
These results suggest that brachioradialis rerouting combined with interosseous membrane release may be a successful means to correct supination deformity of the forearm.
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