TY - JOUR
T1 - Derotational Pronation-producing Osteotomy of the Radius and Biceps Tendon Rerouting for Supination Contractures in Neonatal Brachial Plexus Palsy Patients
AU - Dedeugd, Casey M.
AU - Shin, Alexander Y.
AU - Shaughnessy, William J.
N1 - Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2018
Y1 - 2018
N2 - Forearm supination contractures can occur as a result of neurological derangement of the upper extremity. Primarily, this is observed in patients with neonatal brachial plexus birth palsy. The contractures develop slowly over time and become problematic in childhood as the patients begin requiring forearm pronation for activities of daily living including typing on a keyboard and writing. Although supination contracture is a well-described sequelae of neonatal brachial plexus birth palsy, there is a paucity of literature describing techniques and outcomes for reconstruction and restoration of forearm pronation. The initially described technique included release of the interosseous membrane for flexibility combined with rerouting of part of the biceps tendon to change its biomechanical pull from supination to pronation. More recently, bone and soft tissue procedures have been combined with various forearm osteotomies. We present a combined derotational radial osteotomy and biceps rerouting to realign the forearm in resting pronation and convert the biceps from a supinator to a pronator. This novel surgical technique has not been described as a solution for supination contracture to restore pronation and provide biomechanical advantage of the biceps insertion.
AB - Forearm supination contractures can occur as a result of neurological derangement of the upper extremity. Primarily, this is observed in patients with neonatal brachial plexus birth palsy. The contractures develop slowly over time and become problematic in childhood as the patients begin requiring forearm pronation for activities of daily living including typing on a keyboard and writing. Although supination contracture is a well-described sequelae of neonatal brachial plexus birth palsy, there is a paucity of literature describing techniques and outcomes for reconstruction and restoration of forearm pronation. The initially described technique included release of the interosseous membrane for flexibility combined with rerouting of part of the biceps tendon to change its biomechanical pull from supination to pronation. More recently, bone and soft tissue procedures have been combined with various forearm osteotomies. We present a combined derotational radial osteotomy and biceps rerouting to realign the forearm in resting pronation and convert the biceps from a supinator to a pronator. This novel surgical technique has not been described as a solution for supination contracture to restore pronation and provide biomechanical advantage of the biceps insertion.
KW - derotational osteotomy
KW - neonatal brachial plexus birth palsy
KW - radius and biceps tendon rerouting
UR - http://www.scopus.com/inward/record.url?scp=85041609674&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85041609674&partnerID=8YFLogxK
U2 - 10.1097/BTH.0000000000000181
DO - 10.1097/BTH.0000000000000181
M3 - Article
C2 - 29369125
AN - SCOPUS:85041609674
SN - 1089-3393
VL - 22
SP - 10
EP - 14
JO - Techniques in Hand and Upper Extremity Surgery
JF - Techniques in Hand and Upper Extremity Surgery
IS - 1
ER -