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

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.