[Reconstruction of pronation of the forearm (experiences using the Zancolli operation)]

A supination contracture of the forearm is a severe handicap in paraplegics as well as in brachial plexus pareses, e.g. in operating wheelchairs, supporting the upper part of the body and other daily tasks. For restoration of the pronation of the forearm, Zancolli et al. have suggested transfer of the biceps tendon. Since 1976, we have carried out this operation on 16 patients. These cases involved plexus pareses due to birth trauma, high transverse lesions of the cord with paraplegia. In two patients, there was spastic hemiparesis. The results are presented and discussed. Full active pronation can only rarely be achieved, since this is not possible for biomechanical reasons. However, the function of the arm can be improved in all patients by this operation. In children, this procedure should be carried out at an early stage before buckling of the forearm bones has occurred.