Surgery for cerebral palsy: Part 1. Classification and operative procedures for pronation deformity.
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.
Gschwind
C
C
Hand and Microsurgery Unit, Royal North Shore Hospital, Sydney, Australia.
Tonkin
M
M
D000293:Adolescent; D000328:Adult; D002547:Cerebral Palsy / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005542:Forearm / Q000601:surgery; D006801:Humans; D008297:Male; D011403:Pronation; D013514:Surgical Procedures, Operative / Q000379:methods