A New Technique of Brachioradialis Tendon Rerouting Combined With Osteotomy in Contractures of the Forearm.

Abstract

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.