A Surgical Technique of Radioulnar Osteoclasis to Correct Severe Forearm Rotation Deformities

Summary Twenty-six forearms in 23 patients with marked pronation or supination deformities were treated with osteoclasis. Etiologies included 12 radioulnar synos-toses, five brachial plexus injuries, three hemiplegias, two hemimelias, and four other types of deformities. Drill-assisted osteotomy of both the radius and ulna was followed 10 days later by manipulation to the desired functional position. Dominant extremities were placed in 20° pronation, and nondominant extremities in 20° supination. Range of motion was not significantly changed, but the arc of motion occurred in a more functional hand position. Average correction for 15 pronation deformities was 81° and 69° for 11 supination deformities. Two nonunions healed after bone grafting and there were no instances of neuromuscular compromise. Functional improvement was obtained in 25 of 26 forearms.