Is pronator teres rerouting efficient for correction of pronation deformity in obstetric brachial plexus palsy?

Abstract

Background A forearm pronation deformity is one of the deformities following an obstetric brachial plexus injury that causes functional and cosmetic disability. It is caused by the unrestricted action of the pronator muscles of the forearm in the presence of weak or paralyzed supinators. Surgical intervention by supinator muscle rerouting aims to correct pronation deformity and restore most of the daily function. Aim To evaluate the results of pronator teres rerouting for correction of noncontracted pronation deformity in obstetric brachial plexus palsy. Patients and methods A prospective study was done over a period of 42 months on 18 children presented with pronation deformity without contraction after obstetric brachial plexus palsy aiming for correction of pronation deformity and restoration of supination motion to get some hand-to-mouth movement by doing pronator teres rerouting. The mean age was 9.3 years (5.8–15 years). The mean follow-up was 23.4 months (8–42 months). All patients complete their follow-up. Results The median active supination improved from 5° (0–10°) to 75° (70–80°) with no loss of pronation. All patients were able to get hand-to-mouth movement and brush their teeth and could easily dress themselves. Conclusion Pronator tendon rerouting is a very effective procedure for correcting noncontracted forearm pronation deformity in brachial plexus injury.