A surgical technique for pediatric forearm pronation: brachioradialis rerouting with interosseous membrane release.

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.