Surgical Correction of Supination Deformity in Children with Obstetric Brachial Plexus Palsy

Abstract

We present a series of 40 children who were operated on for supination contracture following severe obstetric brachial plexus palsy. Surgery was done at an average age of 7 years and the mean postoperative follow-up was 4 years. In the 23 cases treated by an open or closed radial osteotomy, the mean intraoperative derotation was 78°, the immediate postoperative position was 29° pronation and it stabilized at follow-up at 17° pronation. Biceps rerouting was performed in 17 cases without any recurrence of supination deformity and the final position was 22° pronation. Some active forearm rotation was obtained in a few cases. These surgical corrections are part of an overall treatment plan and allow the “begging hand” to be corrected to a more functional and less noticeable position.