Logo of The Journal of Bone & Joint Surgery (Br)
Quick search:        
          Advanced Search
Guest Access | Sign In
Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 4, 511-516.
doi: 10.1302/0301-620X.91B4.22204  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow My Folders
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Yam, A.
Right arrow Articles by Fox, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Yam, A.
Right arrow Articles by Fox, M.

The supination deformity and associated deformities of the upper limb in severe birth lesions of the brachial plexus

A. Yam, FAMS(Hand Surg), MRCS, Visiting Fellow1; S. Fullilove, MA, FRCS(Orth), Consultant Orthopaedic Hand Surgeon2; M. Sinisi, MD, Consultant Peripheral Nerve Surgeon1; and M. Fox, FRCS(Orth), Consultant Orthopaedic Surgeon1

1 Royal National Orthopaedic, Hospital, Brockley Hill, Stanmore HA7 4LP, UK.
2 Derriford Hospital, Derriford, Road, Plymouth, Devon PL6, 8DH, UK.

Correspondence should be sent to Dr A. Yam; e-mail: jediyam{at}yahoo.com

We reviewed 42 consecutive children with a supination deformity of the forearm complicating severe birth lesions of the brachial plexus.

The overall incidence over the study period was 6.9% (48 of 696). It was absent in those in Narakas group I (27.6) and occurred in 5.7% of group II (13 of 229), 9.6% of group III (11 of 114) and 23.4% of group IV (18 of 77).

Concurrent deformities at the shoulder, elbow, wrist and hand were always present because of muscular imbalance from poor recovery of C5 and C7, inconsistent recovery of C8 and T1 and good recovery of C6. Early surgical correction improved the function of the upper limb and hand, but there was a tendency to recurrence. Pronation osteotomy placed the hand in a functional position, and increased the arc of rotation of the forearm. The supination deformity recurred in 40% (17 of 42) of those treated by pronation osteotomy alone, probably because of remodelling of the growing bone.

Children should be followed up until skeletal maturity, and the parents counselled on the likelihood of multiple operations.






(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General