{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T09:30:49Z","timestamp":1776936649899,"version":"3.51.4"},"reference-count":18,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"4","license":[{"start":{"date-parts":[[2009,4,1]],"date-time":"2009-04-01T00:00:00Z","timestamp":1238544000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery. British volume"],"published-print":{"date-parts":[[2009,4]]},"abstract":"<jats:p> We reviewed 42 consecutive children with a supination deformity of the forearm complicating severe birth lesions of the brachial plexus. <\/jats:p><jats:p> The overall incidence over the study period was 6.9% (48 of 696). It was absent in those in Narakas group I (27.6) and occurred in 5.7% of group II (13 of 229), 9.6% of group III (11 of 114) and 23.4% of group IV (18 of 77). <\/jats:p><jats:p> Concurrent deformities at the shoulder, elbow, wrist and hand were always present because of muscular imbalance from poor recovery of C5 and C7, inconsistent recovery of C8 and T1 and good recovery of C6. Early surgical correction improved the function of the upper limb and hand, but there was a tendency to recurrence. Pronation osteotomy placed the hand in a functional position, and increased the arc of rotation of the forearm. The supination deformity recurred in 40% (17 of 42) of those treated by pronation osteotomy alone, probably because of remodelling of the growing bone. <\/jats:p><jats:p> Children should be followed up until skeletal maturity, and the parents counselled on the likelihood of multiple operations. <\/jats:p>","DOI":"10.1302\/0301-620x.91b4.22204","type":"journal-article","created":{"date-parts":[[2009,3,31]],"date-time":"2009-03-31T21:53:04Z","timestamp":1238536384000},"page":"511-516","source":"Crossref","is-referenced-by-count":25,"title":["The supination deformity and associated deformities of the upper limb in severe birth lesions of the brachial plexus"],"prefix":"10.1302","volume":"91-B","author":[{"given":"A.","family":"Yam","sequence":"first","affiliation":[{"name":"Royal National Orthopaedic, Hospital, Brockley Hill, Stanmore HA7 4LP, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Fullilove","sequence":"additional","affiliation":[{"name":"Derriford Hospital, Derriford, Road, Plymouth, Devon PL6, 8DH, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Sinisi","sequence":"additional","affiliation":[{"name":"Royal National Orthopaedic, Hospital, Brockley Hill, Stanmore HA7 4LP, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Fox","sequence":"additional","affiliation":[{"name":"Royal National Orthopaedic, Hospital, Brockley Hill, Stanmore HA7 4LP, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"42","reference":[{"key":"R1","unstructured":"Zancolli EA II. Palliative surgery: pronosupination in obstetrical palsy. In: Gilbert A, ed. Brachial plexus injuries. London: Martin Dunitz, 2001:275\u201391."},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200205000-00026"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1054\/JHSB.2001.0647"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200205000-00025"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000141900.85203.ce"},{"key":"R6","unstructured":"Narakas AO. Obstetrical brachial plexus injuries. In: Lamb DW, ed. The paralysed hand: the hand and upper limb. Vol. 2. Edinburgh, etc: Churchill-Livingstone, 1987:116\u201335."},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1016\/S0266-7681(96)80088-X"},{"key":"R8","unstructured":"Birch R, Bonney G, Wynn Parry CB. Birth lesions of the brachial plexus. In: Surgical disorders of the peripheral nerves. First edition. London: Churchill-Livingstone, 1998:216\u201319."},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B8.15975"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.88B2.17185"},{"key":"R11","unstructured":"Raimondi P. Evaluation of the hand. Procs Meeting on obstetric brachial plexus palsy: 1993."},{"key":"R12","unstructured":"O Brien MD (ed) Aids to the examination of the peripheral nervous system. Fourth edition. London: WB Saunders, 2000:1."},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2007.02.124"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.85B3.16351"},{"key":"R15","doi-asserted-by":"crossref","unstructured":"Zancolli EA. Paralytic supination contracture of the forearm. J Bone Joint Surg [Am] 1967;49-A:1275\u201384.","DOI":"10.2106\/00004623-196749070-00003"},{"key":"R16","unstructured":"Blount WP. Osteoclasis for supination deformities in children. 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