The Journal of Bone and Joint Surgery, Vol 66, Issue 1 65-70, Copyright © 1984 by Journal of Bone and Joint Surgery, Inc
The effects of angular and rotational deformities of both bones of the forearm. An in vitro study
RR Tarr, AI Garfinkel and A Sarmiento
In intact fresh cadaver specimens, we experimentally studied angular and
rotatory deformities at the distal and middle levels of the forearm. The
remaining pronation and supination motions were measured. When both bones
of the forearm were angulated with a combined deformity (radio-ulnar or
dorsovolar, or both) of 10 degrees, a loss of pronation-supination of 12.5
+/- 4.5 per cent occurred in the forearms with a distal-third fracture; in
the forearms with a middle-third fracture the average loss was 16.0 +/- 5.7
per cent. Pronation losses were similar for both distal and middle-third
deformities. However, supination losses were much less affected (p less
than 0.01) in forearms with deformities at the distal-third level while the
losses were considered drastic for middle-third deformities. Rotatory
deformities produced losses of pronation-supination that were equal to the
degree of deformity. Clinical Relevance: Study of the artificially created
deformities in cadavera indicated that angular and rotatory deformities of
the forearm of 10 degrees or less result in minimum limitation of
pronation-supination. These degrees of limitation of motion in clinical
practice are easily compensated for and are cosmetically acceptable. The
fact that the perfect anatomical restoration of fracture alignment that
often is obtained with internal fixation does not always result in complete
restoration of motion suggests that: (1) this residual impairment of
function is due to soft-tissue scarring, and (2) the mild angular and
rotatory deformities resulting from nonsurgical treatment of fractures of
the forearm may produce limitations of motion of an equally acceptable
degree.(ABSTRACT TRUNCATED AT 250 WORDS)
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