Paralytic Supination Contracture of the Forearm

¹ Hospital for Joint Diseases, New York

Supination contracture of the forearm, not uncommonly seen in Erb's palsy and occasionally seen in infantile paralysis, follows the selective palsy of the muscles arising from the medial epicondyle of the humerus. The supination deformity of the forearm is the primary link in a chain of deformities which consists in a triple deformity of the shoulder in flexion, abduction, and medial rotation, a flexion contracture of the elbow, and hyperextension of the wrist. The first step in correction is to return the shoulder to the neutral position. This must be done before correcting the supination deformity or the dorsiflexion of the wrist.

Operations used to relieve supination contracture of the forearm, especially osteotomy of the radius, are described. After section of the radius, there is dorsal and ulnar angulation of the radius by non-axial torsion of the distal fragment. The value of axial torsional osteotomy of the ulna to relieve supination contracture is noted.

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