United Brachial Plexus Network

I was wondering if there are any children who gained supination from surgery and retained it? It seems as if many children come out of their splints having supination, and than lose it again. This is the case for my child. Given all the therapy post op, it's so discouraging that the supination is once again lost. This has happened with two surgeries for my child. We are trying theratogs along with a supination strap to "maintain neutral". I realize there are so many muscles and nerves involved with supination, and it's difficult to pinpoint why it's not happening, I'm just afraid over time if we do not continue strapping, my child will be stuck in pronation.
Has anyone had any success gaining supination for a pronation contracture with a forearm osteotomy and maintained it?

Our son is 18 months post-ACR and supination is one thing that has actually gotten better and better since the surgery. In his case, we believe his supinator did have function prior to surgery, but.not enough to be effective. In his case, the shoulder surgery helped "reveal" more muscle recovery than had been apparent. By putting the shoulder in a better position, what supination is there is a lot more effective which encourages the child to keep trying which can eventually strengthen the motion. But I don't think it will provide any active supination if some wasn't there to start with.

I think tendon transfers in the wrist or the forearm osteotomy are the only way to get supination in the forearm if there isn't any nerve recovery to the supinator.

I hope you get some good feedback on all your options.

Kate

I really dont have any info reguarding supination but I did was to say that what ever you do be carefull not to sacrifice too much pronantion. I cant actively pronate my arm and find that a way more usefull position than supination. If you think about it many things you do during the day require pronation yet not as many seem to require supination past neutral.

Good luck achieving both motions!!!

Hugs,
Amy 19 ROBPI from MN

We had full supination then we lost it, then we had it partially and then we lost it. Now we have so much internal rotation that it's even hard to passively stretch. Wish I had an answer to this ongoing issue. It doesn't seem like there's anything we can do to change this on a long term basis.

Our son finally got supination after the acromioplasty (not osteotomy) and it has maintained and improved ever since. So yes, it can happen, although his original injury may not be the same as your child's. We have been happy with his progress!

EVery child is different.

my child is 8 and had humeral and forearm osteotomy and still cannot supinate

Thanks for posting about the osteotomies. That's helpful to know. Thanks for being honest.

Our child gained a lot of supination after her ACR at age 2 years. She had the ACR because her shoulder was subluxed, so once her shoulder was allowed to be in a correct position, it allowed her to have a more natural position and movement. No regression as far as the supination, only continued improvement with therapy.

Tanya in NY
Amber's Mom, ROBPI, almost 4 years old

Our daughter had both the Tendon release & Tendon transfer surgeries done @ 2yrs. She is now 3. She has improved dramatically. I don't consider her to have "lost" supination. When she came out of her cast & splint supination was so extreme for being in that position for so long. Now she carries her arm in a much more relaxed position. She has continued to improve. She had a severe injury and by the time she was 2mths she was so internally rotated w/ elbow overextended that we chose to have the intial nerve graph surgery done. Every injury is different and so results will vary. I hope with the continued effort and awarness of these injuries we will all have more favorable results. Hang in there!