11B Forearm supination contracture in children: surgical correction and influence in the upper extremity
Shoulder function was not affected by any of these interventions. Elbow extension was decreased at last control after both surgical procedures, probably due to progressive biceps contracture rather than the procedures themselves. Improvement in wrist and finger extension was mainly due to better biomechanical conditions and a more physiologic positioning of the hand. The group of patients that had an osteotomy done had a worse preoperative deformity, and although the intraoperative correction of the deformity obtained was similar in both groups, there was a greater tendency of the osteotomy group to recurrences. All recurrences were secondary to radius osteotomies, probably because some passive movement was still present at the time of the osteotomy and allowed the active supinator muscles to restore the deformity; if biceps rerouting was associated at the same surgical intervention, recurrences would probably be avoided. Radius osteotomy produced a more important ‘blocking ’ of rotatory movement in the forearm, but this did not seem to significantly impair the functional result; active and passive range of motion was not measured in these patients.