Optimal Forearm Position Allowing Maximum Hand Function: A Quasi-experimental Study in Adolescent Children.

Area of Science:

• Orthopedic surgery
• Rehabilitation medicine
• Biomechanics

Background:

• Forearm fusion (arthrodesis) is often necessary for congenital/acquired upper-limb disorders.
• Optimal forearm position for maximum upper-limb function remains debated.
• Existing evidence is limited, often relying on personal preference.

Purpose of the Study:

• To determine the ideal forearm position for maximum upper-limb function.
• To investigate optimal fusion positions for both dominant and non-dominant limbs.
• To provide evidence-based guidance for forearm arthrodesis.

Main Methods:

• 15 healthy adolescents participated in the study.
• Custom adjustable braces simulated forearm arthrodesis in five positions.
• Sollerman's hand function test assessed functional outcomes.

Main Results:

• The mid-prone position yielded the best overall function for unilateral and bilateral upper limbs.
• For bilateral fusion, dominant limb in mid-prone and non-dominant in 45° supination is recommended.
• Limb dominance influences optimal positioning for bilateral, but not unilateral, fusion.

Conclusions:

• The ideal forearm fusion position is mid-prone for unilateral cases, regardless of limb dominance.
• Bilateral forearm fusion requires consideration of limb dominance for optimal functional outcomes.
• This study provides evidence to guide surgical decisions in forearm reconstruction.