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Journal of Hand Surgery (British and European Volume)
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Surgery for Cerebral Palsy: Part 1. Classification and Operative Procedures for Pronation Deformity

C. GSCHWIND
M. TONKIN

From the Hand and Microsurgery Unit, Royal North Shore Hospital and The Spastic Centre of New South Wales, Sydney, Australia

Correspondence: M. A. Tonkin, Hand and Microsurgery Unit, Royal North Shore Hospital, St Leonards, NSW 2065, Australia.

32 patients with cerebral palsy underwent operations for pronation deformity. The deformity is classified into four groups. Patients in group 1 are capable of supination beyond neutral. No surgery is necessary. Those in group 2 are able to supinate to the neutral position. A pronator quadratus release is advised and may be combined with a flexor aponeurotic release. In group 3, patients have no active supination. However a full range of passive supination is readily achieved. A pronator teres transfer is advised. Patients in group 4 have no active supination. Full passive supination may be present, but is tight. A flexor aponeurotic release and a pronator quadratus release may unmask active supinator activity. An active transfer for supination is possible as a secondary procedure.

Journal of Hand Surgery (British and European Volume), Vol. 17, No. 4, 391-395 (1992)
DOI: 10.1016/S0266-7681(05)80260-8
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Pronator teres transfer to correct pronation deformity of the forearm after an obstetrical brachial plexus injury
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