Derotation osteotomy of the forearm in management of paralytic supination deformity.

Ten children with supination deformity of the forearm due to obstetric paralysis were treated by pronation osteotomy of the radius and ulna. In two patients release of the interosseous membrane was added. The main achievement of the operation was an improved position of rest, which rendered a mechanical advantage for the basic function of the hand in grasping medium-sized objects. Preliminary results of three other patients who recently underwent rerouting of the biceps tendon concurrently or following the osteotomy are encouraging. One patient who had both procedures underwent rerouting of the biceps, which resulted in a gain of 135 degrees of active pronation.