The authors investigated the effect on forearm rotation of rotational osteotomies of the radius and ulna. Fifteen and 30 degrees rotational osteotomies were made in the proximal and distal one-thirds of the radius and ulna in 10 cadaver specimens. A rotational osteotomy of the proximal ulna resulted in the greatest gain in the rotated direction with only minimal loss of rotation in the opposite direction.
The etiologies of limited forearm pronation and supination include malunion of the radius and/or ulna, soft-tissue contracture of the proximal and/or distal radioulnar joints, contracture of the interososeous membrane, birth palsy, dislocation of the radial head, and heterotopic bone. In malunion cases, corrective osteotomy is best carried out at the site of bone injury. When the site of torsional deformity is unclear and conservative treatment measures have failed to improve functional forearm rotation, rotational osteotomy of the proximal ulna, in addition to a selective soft tissue release, may be beneficial.
Osteotomy, Rotation, Malunion, Forearm, Radius, Ulna