title: Pronator teres transfer for forearm and wrist deformity in cerebral palsy children.
abstract: BACKGROUND
  Forearm pronation and wrist flexion contracture can be a disability for daily living care and 2-hand function in cerebral palsy (CP) children. It may be beneficial to improve their posture and hand-grip power for better functional outcome. The purpose of our study was to investigate the outcome of pronator transfer in CP children.
  
  
  METHODS
  Seventeen spastic CP patients (14 hemiplegic, 3 diplegic; 14 male, 3 female; mean age, 12 y 5 mo) underwent pronator teres transfer for forearm pronation and wrist flexion contractures. The mean follow-up period was 46 months. We recorded Gross Motor Function Classification System level, modified Ashworth scale, forearm and wrist range of motion, forearm resting position, grip power, and 3 basic daily living skills preoperatively and postoperatively. Paired t test was used for statistical analysis.
  
  
  RESULTS
  The average forearm active supination gained 80.9 degrees (P<0.05) and the active forearm pronation lost 22 degrees (P<0.05), with average postoperative total active forearm range of motion 130.9 degrees (P<0.05). The average active wrist extension gained 76.9 degrees (P<0.05) and the active wrist flexion lost 31.8 degrees (P<0.05). The average grip power gained 4.5 kg (P<0.05). The average forearm resting position improved to 10 degrees pronation (P<0.05). The basic daily living skills showed great improvement.
  
  
  CONCLUSIONS
  Our procedure improved the functional outcome in wrist extension and decreased the forearm pronation. Therefore, significant grip-strength enhancement and better forearm posture was noted. It is an additional armamentarium in the management of upper extremity disability in CP children.
  
  
  METHODS
  Level IV-case series.
authors: *Department of Orthopedic Surgery, Landseed Hospital, Taoyuan County Departments of †Orthopedic Surgery ‡Physical Medicine & Rehabilitation, National Taiwan University Hospital §Center for Evidence-Based Medicine, Taipei Medical University, Taipei, Taiwan.
authors: Jimmy J T
authors: JJ
authors: Ho
authors: Ting-Ming
authors: TM
authors: Wang
authors: Jeng-Yi
authors: JY
authors: Shieh
authors: Kuan-Wen
authors: KW
authors: Wu
authors: Shier-Chieg
authors: SC
authors: Huang
authors: Ken N
authors: KN
authors: Kuo
mesh_terms: D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology; D002648:Child; D003286:Contracture / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005260:Female; D005542:Forearm / Q000473:pathology / Q000503:physiopathology; D018737:Hand Strength; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000601:surgery*; D011184:Postoperative Period; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D013624:Taiwan; D016378:Tissue Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014953:Wrist / Q000473:pathology / Q000503:physiopathology