Treatment of pronation contractures of the forearm in cerebral palsy by changing the insertion of the pronator radii teres.

In twenty-two patients with cerebral palsy and a pronation contracture of the forearm, transfer of the pronator radii teres posteriorly to the anterolateral border of the radius converted it from a pronator to a supinator. Of the twenty-two patients so treated and followed for two to six years, 82 per cent were judged to have a good to excellent result since they had gained an average of 46 degrees of active supination compared with their preoperative status. There was no loss of motion with the passage of time and, determined by palpation, active contract of the transferred pronator teres was evident during voluntary supination. The procedure allowed the patients to improve function significantly by giving them the ability to supinate the forearm during activities requiring axial rotation of the forearm.