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Radial Head Dislocation
Published in Benjamin Joseph, Selvadurai Nayagam, Randall T Loder, Anjali Benjamin Daniel, Essential Paediatric Orthopaedic Decision Making, 2022
She had cubitus varus, a prominent postero-laterally dislocated radial head, a bowed ulna and a short forearm. Supination was markedly restricted and painful. She had a fixed flexion deformity of 40 degrees of the elbow (Figure 28.2) and varus/valgus instability at her elbow.
Examination of a Child with Birth Brachial Plexus Palsy
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Satyaswarup Tripathy, Mohsina Subair
The common deformities that occur are as follows: Shoulder deformities: Limited abduction with good external rotation.Limited external rotation with good abduction.Limited abduction and external rotation.Elbow deformities: Elbow flexion contracture.Forearm deformities: Pronation deficit.Supination deficit.Deficit in both directions of rotation.
The Anatomy of Joints Related to Function
Published in Verna Wright, Eric L. Radin, Mechanics of Human Joints, 2020
More biomechanically, the articular surfaces of the talo-navicular and calcaneocuboid articulations each have two planes of curvature (the former ellipsoid and the latter saddle-shaped in general form). When the subtalar joints are pronated, the major planes of curvature are parallel and the navicular-cuboid unit can swing freely in the plane of these curvatures about the oblique axis of the midtarsal joint (Fig. 8). In subtalar supination, the planes of curvature (and therefore their respective axes) are divergent and the ligaments tighten, prohibiting this motion (71). Thus the midtarsal joint is fully mobile in subtalar pronation but progressively loses its ability to pronate about its oblique axis as thesubtalar joint moves toward supination. In full subtalar supination, the midtarsal joint is forced into full supination, and this relationship is important for the normal functioning of the foot during walking (72). The midtarsal joint gains most of its mobility from its oblique axis, which is more oblique to the sagittal plane but otherwise similarly oriented to the subtalar axis. The second axis of the midtarsal joint is virtually anteroposterior (Fig. 8) (53); it has a small range of movement (72) but is crucial for the final locking of the joint at push-off.
Comparison of maximal isometric forearm supination torque in two elbow positions between subjects with and without limited forearm supination range of motion
Published in Physiotherapy Theory and Practice, 2021
Gyeong-Tae Gwak, Ui-Jae Hwang, Sung-Hoon Jung, Jun-Hee Kim, Moon-Hwan Kim, Oh-Yun Kwon
Supination involves a rotatory motion of forearm and hand so that the palm faces anterior (Neumann, 2010). Approximately 75° of supination occurs at the forearm articulations, and the remaining 15° occurring at the wrist (Magee, 2014). This movement is indispensable for functional activities of daily living such as opening a door, using a fork, and performing personal hygiene (Morrey, Askew, and Chao, 1981; Raiss et al., 2007; Sardelli, Tashjian, and MacWilliams, 2011). Forearm supination is often accompanied by movement at adjacent joints, such as intercarpal rotation and shoulder external rotation, during functional activities (Flowers, Stephens-Chisar, LaStayo, and Lou, 2001; Murgia, Kyberd, and Barnhill, 2010; Neumann, 2010; Pereira, Thambyah, and Lee, 2012). Therefore, when studying supination, it is important to differentiate motion of the forearm, from motion of the wrist and shoulder (Neumann, 2010; Sahrmann, 2011; Szekeres, 2017).
Evaluation of function following rehabilitation after distal biceps tendon repair
Published in European Journal of Physiotherapy, 2020
Maria Liljeros, Monika Fagevik Olsén, Gunilla Kjellby Wendt
There is no consensus concerning rehabilitation after distal biceps tendon repair [22]. Clinically, rehabilitation is often performed according to the surgeon’s treatment preferences. Earlier retrospective trials following a single-incision technique have described that the arm has been immobilised in a cast or orthosis for 1–2 weeks after surgery [10,21,23]. Thereafter, gradual ROM training and strength training of flexors was introduced under the guidance of a physiotherapist/rehabilitation therapist. Between eight and twelve weeks postoperatively restrictions on activity were removed, and patients were allowed three month after surgery to return to their sporting activities [10,21,23]. The rehabilitation programme followed by the participants in our study was slower with a longer period of immobilisation (6 weeks), initially in a cast and thereafter in an orthosis, with gradual active ROM training once the cast was removed. Strength training started after 8–10 weeks, with no restrictions after 4–6 months. It appears that regardless of the length of immobilisation and/or type of rehabilitation some patients do not fully regain supination. This may instead be dependent on biomechanical or surgical factors.
Long-term outcomes of corrective osteotomy for malunited fractures of the distal radius
Published in Journal of Plastic Surgery and Hand Surgery, 2020
Ingrid Andreasson, Gunilla Kjellby-Wendt, Monika Fagevik-Olsén, Ylva Aurell, Michael Ullman, Jón Karlsson
For different movement directions, the restoration of the range of motion arc varied from 0 (for two individuals the radial deviation was 0° in the operated wrist) to 100%. It can be presumed that, for the individual, it is the sum of range of motion in all directions that matters. In any case, earlier studies have shown that supination is of great importance for the ability to perform activities [29]. In the present study, supination was restored to 89%, which can be regarded as an excellent result. However, only 61% of the patients rated their function as good or excellent compared with 72–76% in some previous studies [30,31]. This indicates that range of motion and the grip strength are not the only outcome measurements that should be used to determine the function of the wrist and hand.