Conservative treatment of pronational contracture of the forearm in children with cerebral palsy

Abstract

Aim. We aimed to evaluate the effectiveness of conservative treatment for pronational contracture of the forearm, depending on the contracture severity.
 Materials and methods. This study was based on the results of the examination and treatment of children experiencing cerebral palsy with upper limb involvement. The main criterion for patient selection was the presence of pronational contracture of the forearm, both isolated and in combination with other contractures in the upper limb joints. Three patient groups were formed based on the pronounced pronation contracture of the forearm.
 Results and conclusions. Previous research has established that with the increase in the degree of severity of pronation contracture, the effectiveness of conservative treatment decreases in general. Conservative treatment of patients with a deficiency of active supination of the forearm of > 90° is ineffective. The use of botulinum toxins type A and RFD in groups II and III is ineffective. Conservative treatment with botulinum toxins type A achieved good results only in patients of group I.
 The RFD method had a longer lasting; however, there were significantly more complications. The use of botulinum toxins type A (m. pronator teres) among patients with pronational contracture of the forearm with the possibility of active supination of the forearm > 90° significantly improved the result of basic conservative treatment.