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For Some Kids, the Arm Bone's Connected to the...Arm Bone

Can you imagine never being able to dribble a ball, play the piano, tie your shoes, or type? This could happen if your forearm was always held with the hand palm up, a position called "supination." What could cause this loss of forearm motion, and what can be done about it?

Injury, infection, birth defects, and surgery to remove a tumor can leave the two bones in the forearm unable to move. These two bones normally rotate, allowing the hand to turn palm up and palm down. Since 1921, an operation to join, or fuse, these two bones together in a better position has been used in such cases. This fusion, called an arthrodesis connects the two forearm bones into one.

A new study has added another use of this type of bone fusion. Children with paralysis of the arm can now be helped with this operation. In six cases of arm weakness in which the arm was positioned palm up, the bones were fused together. These children were born with this problem because of nerve damage from birth or polio. The result was to put the forearm in a "handshake position," with the palm turned down slightly.

This new position helped the children to hold objects, lift items, ride a bicycle, and in one case, use a keyboard. For children who can't turn their hands over, connecting the bones together in a new position helps them use their hands in new ways.

References: A. Wang, MD, et al. One-Bone Forearm Fusion for Pediatric Supination Contracture Due to Neurologic Deficit. In The Journal of Hand Surgery. July 2001. Vol. 26A. No. 4. Pp. 611-616.

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