{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:52:49Z","timestamp":1786978369711,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Forearm supination posture is a common secondary deformity in brachial plexus birth injury (BPBI), leading to functional impairment of the upper limb, as pronation is required for most activities of daily living. The purpose of this report is to analyze a series of children with forearm supination deformity secondary to severe BPBI and complete pronation palsy, who were treated with forearm fusion in slight pronation through the creation of a radioulnar synostosis using a novel distal pedicled vascularized ulnar periosteal flap (VUPF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective analysis. Inclusion criteria included complete pronation paralysis with active wrist extension present and a minimum of 6\u2009months follow\u2010up. Demographic information, preoperative passive pronation, postoperative forearm rotational position, radiographic union, and parental satisfaction using a 4\u2010point Likert\u2010type ordinal scale (1\u2010very unsatisfied, 2\u2010unsatisfied, 3\u2010satisfied, and 4\u2010extremely satisfied) were analyzed. A retrograde distally pedicled vascularized ulnar periosteal flap covering approximately one third of the ulnar length and based on the posterior interosseous vessels\u2014was transferred to the dorsal aspect of the radius and fixed for 4\u2009weeks using Kirschner wires.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty children with a mean age of 53.6\u2009months (range 20 to 115\u2009months) and a mean passive forearm pronation of 9\u00b0 (range 60\u00b0 to 60\u00b0) with a mean follow\u2010up of 13.7\u2009months (range 8 to 18\u2009months) were included in this report. All except one had complete residual BPBI. A partially ossified radioulnar synostosis was radiographically observed at 4\u2009weeks in all cases. Mean immediate postoperative and final follow\u2010up rotational values were similar, measuring 15\u00b0 of pronation (range 0\u00b0 to 30\u00b0). All parents reported extreme satisfaction with both functional and cosmetic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Forearm fusion in slight pronation by creating a radioulnar synostosis using a distal pedicled vascularized ulnar periosteal flap is an effective and fast technique to correct supination deformity and might be considered among other reported strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/micr.70088","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T08:30:02Z","timestamp":1751877002000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Forearm Synostosis Using A Vascularized Pedicled Ulnar Periosteal Graft for Supination Deformity in Brachial Plexus Birth Injury"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1759-9868","authenticated-orcid":false,"given":"Francisco","family":"Soldado","sequence":"first","affiliation":[{"name":"Pediatric Hand Surgery and Microsurgery Unit \u201cInstituto de Investigaci\u00f3n Sanitaria HM Hospitales\u201d  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"D\u00edaz\u2010Gallardo","sequence":"additional","affiliation":[{"name":"Pediatric Orthopaedic Unit Hospital Sant Pau  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9028-2579","authenticated-orcid":false,"given":"Juliana","family":"Rojas\u2010Neira","sequence":"additional","affiliation":[{"name":"Hand Surgery and Microsurgery Department, Ortomove Group Hospital Angeles Lomas y Centro Medico ABC Campus Santafe  M\u00e9xico City Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ismaray","family":"De Avila\u2010Diaz","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedic Unit Hospital Pedi\u00e1trico Universitario William Soler  La Habana Cuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dashiell","family":"Ca\u00f1izares\u2010Betancourt","sequence":"additional","affiliation":[{"name":"Orthopaedic Department Complejo Ortopedico FranK Pa\u00eds  La Habana Cuba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Villafranca\u2010Solano","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics and Traumatology Hospital Universitario Son Espases  Palma Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000141900.85203.ce"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1054\/JHSB.2001.0647"},{"issue":"2","key":"e_1_2_8_4_1","first-page":"300","article-title":"Osteoclasis for Supination Deformities in Children","volume":"22","author":"Blount P. 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