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Forearm pronation contracture

MedGen UID:
1813106
•Concept ID:
C0409341
•
Anatomical Abnormality
Synonym: Pronation contracture of the forearm
 
HPO: HP:0034395

Definition

A contracture that limits the ability of the forearm to stabilize the hand in supiation (supination refers to a rotation of the forearm that causes the palm and forearm to face upwards), meaning that the palm is fixed in a downward orientation. Restriction of supination/pronation can occur at the elbow (radial-humeral joint), at the wrist (radial-ulnar joint), and anywhere in between. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVForearm pronation contracture

Professional guidelines

PubMed

Supination Contractures in Brachial Plexus Birth Palsy: Long-Term Upper Limb Function and Recurrence After Forearm Osteotomy or Nonsurgical Treatment.
Metsaars WP, Henseler JF, Nagels J, Nelissen RG
J Hand Surg Am 2017 Nov;42(11):925.e1-925.e11. Epub 2017 Aug 30 doi: 10.1016/j.jhsa.2017.06.002. PMID: 28869062
The management of elbow instability using an internal joint stabilizer: preliminary results.
Orbay JL, Mijares MR
Clin Orthop Relat Res 2014 Jul;472(7):2049-60. doi: 10.1007/s11999-014-3646-2. PMID: 24789029Free PMC Article
Pathogenesis and management of deformities of the elbow, wrist, and hand in late neonatal brachial plexus palsy.
Sebastin SJ, Chung KC
J Pediatr Rehabil Med 2011;4(2):119-30. doi: 10.3233/PRM-2011-0169. PMID: 21955970

Recent clinical studies

Etiology

Natural history of elbow flexion and forearm rotation contractures in obstetric brachial plexus injury.
Hems T
J Hand Surg Eur Vol 2022 Dec;47(11):1121-1127. Epub 2022 Sep 1 doi: 10.1177/17531934221121912. PMID: 36050833
The One-Bone Forearm in Children: Surgical Technique and a Retrospective Review of Outcomes.
Clippinger BB, Plucknette BF, Soldado F, Turvey BR, Barrera-Ochoa S, Kozin SH, Zlotolow DA
J Hand Surg Am 2022 Feb;47(2):189.e1-189.e9. Epub 2021 Jun 8 doi: 10.1016/j.jhsa.2021.04.009. PMID: 34112543
Loss of pronation-supination in patients with heterotopic ossification around the elbow.
Vasileiadis GI, Ramazanian T, Kamaci S, Bachman DR, Park SE, Thaveepunsan S, Fitzsimmons JS, O'Driscoll SW
J Shoulder Elbow Surg 2019 Jul;28(7):1406-1410. Epub 2019 Jan 23 doi: 10.1016/j.jse.2018.10.029. PMID: 30685280
Forearm Pronation Osteotomy for Supination Contracture Secondary to Obstetrical Brachial Plexus Palsy: A Retrospective Cohort Study.
Gladstein AZ, Sachleben B, Ho ES, Anthony A, Clarke HM, Hopyan S
J Pediatr Orthop 2017 Sep;37(6):e357-e363. doi: 10.1097/BPO.0000000000001053. PMID: 28719548
Pediatric floating elbow.
Ring D, Waters PM, Hotchkiss RN, Kasser JR
J Pediatr Orthop 2001 Jul-Aug;21(4):456-9. PMID: 11433156

Diagnosis

The One-Bone Forearm in Children: Surgical Technique and a Retrospective Review of Outcomes.
Clippinger BB, Plucknette BF, Soldado F, Turvey BR, Barrera-Ochoa S, Kozin SH, Zlotolow DA
J Hand Surg Am 2022 Feb;47(2):189.e1-189.e9. Epub 2021 Jun 8 doi: 10.1016/j.jhsa.2021.04.009. PMID: 34112543
Functional Elbow Range of Motion in Children and Adolescents.
Valone LC, Waites C, Tartarilla AB, Whited A, Sugimoto D, Bae DS, Bauer AS
J Pediatr Orthop 2020 Jul;40(6):304-309. doi: 10.1097/BPO.0000000000001467. PMID: 32501919
Pronator teres transfer for forearm and wrist deformity in cerebral palsy children.
Ho JJ, Wang TM, Shieh JY, Wu KW, Huang SC, Kuo KN
J Pediatr Orthop 2015 Jun;35(4):412-8. doi: 10.1097/BPO.0000000000000276. PMID: 25075892
Florid reactive periostitis of the forearm with pronation and supination contracture.
Kodama N, Ishida M, Ueba H, Imai S, Matsusue Y
J Orthop Sci 2015 Nov;20(6):1122-6. Epub 2014 Jun 30 doi: 10.1007/s00776-014-0596-1. PMID: 24975379
The management of elbow instability using an internal joint stabilizer: preliminary results.
Orbay JL, Mijares MR
Clin Orthop Relat Res 2014 Jul;472(7):2049-60. doi: 10.1007/s11999-014-3646-2. PMID: 24789029Free PMC Article

Therapy

Comparison of outcome between operative treatment and constraint-induced movement therapy for forearm and wrist deformities in cerebral palsy. A randomized controlled trial.
Tawonsawatruk T, Prusmetikul S, Kanchanathepsak T, Patathong T, Klaewkasikum K, Woratanarat P, Panuwannakorn M, Vongpipatana S
Hand Surg Rehabil 2022 Apr;41(2):258-264. Epub 2022 Feb 3 doi: 10.1016/j.hansur.2021.12.012. PMID: 35124285
Derotational Pronation-producing Osteotomy of the Radius and Biceps Tendon Rerouting for Supination Contractures in Neonatal Brachial Plexus Palsy Patients: A Review of 20 Cases.
DeDeugd CM, Shin AY, Shaughnessy WJ
J Pediatr Orthop 2019 May/Jun;39(5):e366-e372. doi: 10.1097/BPO.0000000000001305. PMID: 30969948
The management of elbow instability using an internal joint stabilizer: preliminary results.
Orbay JL, Mijares MR
Clin Orthop Relat Res 2014 Jul;472(7):2049-60. doi: 10.1007/s11999-014-3646-2. PMID: 24789029Free PMC Article
Dynamic splinting of forearm rotational contracture after distal radius fracture.
Shah MA, Lopez JK, Escalante AS, Green DP
J Hand Surg Am 2002 May;27(3):456-63. doi: 10.1053/jhsu.2002.33196. PMID: 12015720
Pediatric floating elbow.
Ring D, Waters PM, Hotchkiss RN, Kasser JR
J Pediatr Orthop 2001 Jul-Aug;21(4):456-9. PMID: 11433156

Prognosis

The Spastic Upper Extremity in Children: Multilevel Surgical Decision-making.
Chaudhry S, Bhardwaj P, Venkatramani H, Sabapathy SR
J Am Acad Orthop Surg 2021 May 1;29(9):e416-e426. doi: 10.5435/JAAOS-D-20-00719. PMID: 33883454
Pronator teres selective neurectomy in children with cerebral palsy.
Helin M, Bachy M, Stanchina C, Fitoussi F
J Hand Surg Eur Vol 2018 Oct;43(8):879-884. Epub 2018 Jun 5 doi: 10.1177/1753193418780590. PMID: 29871566
One-bone forearm osteodesis and biceps re-routing to correct severe supination contracture in a paediatric patient with late obstetric brachial plexus palsy.
Monreal R
Int Orthop 2018 Aug;42(8):1975-1978. Epub 2018 Jan 12 doi: 10.1007/s00264-017-3753-2. PMID: 29327223
Forearm Pronation Osteotomy for Supination Contracture Secondary to Obstetrical Brachial Plexus Palsy: A Retrospective Cohort Study.
Gladstein AZ, Sachleben B, Ho ES, Anthony A, Clarke HM, Hopyan S
J Pediatr Orthop 2017 Sep;37(6):e357-e363. doi: 10.1097/BPO.0000000000001053. PMID: 28719548
Corrective osteotomies and osteosynthesis for supination contracture of the forearm in children.
Rolfe KW, Green TA, Lawrence JF
J Pediatr Orthop 2009 Jun;29(4):406-10. doi: 10.1097/BPO.0b013e3181a6bf90. PMID: 19461386

Clinical prediction guides

Functional Elbow Range of Motion in Children and Adolescents.
Valone LC, Waites C, Tartarilla AB, Whited A, Sugimoto D, Bae DS, Bauer AS
J Pediatr Orthop 2020 Jul;40(6):304-309. doi: 10.1097/BPO.0000000000001467. PMID: 32501919
Metallic Press-fit Radial Head Replacement for Radial Head Fractures.
Jung KJ, Nho JH, Wang SD, Hong YC, Kim BS
Orthopedics 2019 Nov 1;42(6):e545-e551. Epub 2019 Jun 13 doi: 10.3928/01477447-20190604-07. PMID: 31185117
Loss of pronation-supination in patients with heterotopic ossification around the elbow.
Vasileiadis GI, Ramazanian T, Kamaci S, Bachman DR, Park SE, Thaveepunsan S, Fitzsimmons JS, O'Driscoll SW
J Shoulder Elbow Surg 2019 Jul;28(7):1406-1410. Epub 2019 Jan 23 doi: 10.1016/j.jse.2018.10.029. PMID: 30685280
Forearm Pronation Osteotomy for Supination Contracture Secondary to Obstetrical Brachial Plexus Palsy: A Retrospective Cohort Study.
Gladstein AZ, Sachleben B, Ho ES, Anthony A, Clarke HM, Hopyan S
J Pediatr Orthop 2017 Sep;37(6):e357-e363. doi: 10.1097/BPO.0000000000001053. PMID: 28719548
Biomechanical assessment of brachioradialis pronatorplasty.
Bekler HI, Ozkan T
Acta Orthop Traumatol Turc 2011;45(2):109-14. doi: 10.3944/AOTT.2011.2337. PMID: 21610309

Recent systematic reviews

The Use of Botulinum Toxin Injection for Brachial Plexus Birth Injuries: A Systematic Review of the Literature.
Buchanan PJ, Grossman JAI, Price AE, Reddy C, Chopan M, Chim H
Hand (N Y) 2019 Mar;14(2):150-154. Epub 2018 Mar 13 doi: 10.1177/1558944718760038. PMID: 29529875Free PMC Article

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