Nagy Ladislav, Trache Tudor, Reissner Lisa
Department of Hand Surgery, Balgrist University Hospital, Zurich, Switzerland.
Tech Hand Up Extrem Surg. 2025 Sep 1;29(3):e0522. doi: 10.1097/BTH.0000000000000522.
Rotational deformities of the forearm occur due to neurological imbalance of pro/supinating forces, commonly seen in brachial plexus birth injury. Brachioradialis rerouting has been described for the correction of active pronation or supination deficits. Fixed deformities cannot be addressed by soft tissue procedures alone, and need derotational osteotomies. More recently, techniques combining biceps rerouting and forearm osteotomy have been described. We present an alternative technique to correct fixed rotational forearm deformities by derotational forearm osteotomy and brachioradialis tendon rerouting. The technique can be used to correct both supination and pronation deformities, because the brachioradialis tendon can be rerouted to support either of the 2. No tenotomy and no tendon reconstruction has to be performed. This allows for early mobilization and eliminates the risk of complications at the site of tendon reconstruction.
前臂旋转畸形是由于旋前/旋后力量的神经失衡所致，常见于臂丛神经产伤。已描述了通过肱桡肌改道来纠正主动旋前或旋后功能障碍。单纯的软组织手术无法解决固定畸形，需要进行旋转截骨术。最近，已描述了将肱二头肌改道与前臂截骨术相结合的技术。我们提出了一种通过前臂旋转截骨术和肱桡肌腱改道来纠正固定性前臂旋转畸形的替代技术。该技术可用于纠正旋前和旋后畸形，因为肱桡肌腱可以改道以支持两者中的任何一种。无需进行肌腱切断术和肌腱重建。这允许早期活动，并消除了肌腱重建部位的并发症风险。
