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

J Hand Surg Am. 2004 Jan;29(1):22-7. doi: 10.1016/j.jhsa.2003.10.002.


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.

MeSH terms

  • Brachial Plexus / injuries*
  • Brachial Plexus / physiopathology
  • Child
  • Child, Preschool
  • Female
  • Forearm / physiopathology
  • Forearm / surgery*
  • Humans
  • Male
  • Membranes / surgery*
  • Paralysis, Obstetric / physiopathology
  • Paralysis, Obstetric / surgery*
  • Pronation / physiology*
  • Range of Motion, Articular / physiology
  • Supination / physiology
  • Tendon Transfer / methods*
  • Treatment Outcome