Cerebral Palsy-Comparison of pronator tenotomy and pronator rerouting in children with spastic cerebral palsy

Comparison of pronator tenotomy and pronator rerouting in children with spastic cerebral palsy

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This study compared two surgical procedures, pronator teres tenotomy and pronator teres rerouting, for treating pronation contracture of the forearm in children with spastic cerebral palsy. Pronation deformity of the forearm limits the functional use of the hand in these children. The study included 16 patients who underwent pronator teres tenotomy and 41 patients who underwent pronator teres rerouting. On average, the patients who underwent rerouting were older (7 years and 3 months) compared to patients who underwent tenotomy (4 years and 3 months). The follow-up period averaged 21 months for rerouting and 94 months for tenotomy. The results showed that patients who underwent rerouting had a greater increase in active supination of the forearm (average gain of 78 degrees) compared to those who underwent tenotomy (average gain of 54 degrees). No patient lost active range of motion during follow-up. Although tenotomy increased active supination, rerouting provided greater active supination of the forearm. The study concluded that rerouting of the pronator teres muscle is an advantageous procedure for improving active supination in children with cerebral palsy. The study found no surgical complications in either group. The authors also observed that patients with impaired sensibility or low intelligence quotient had similar improvements in active supination compared to those with intact sensibility. The study suggests that the ability to initiate voluntary activity of the affected extremity is more important than impaired sensibility in determining surgical candidacy.

Keywords

surgical procedures

pronator teres tenotomy

pronator teres rerouting

pronation contracture

forearm

children

spastic cerebral palsy

functional use of hand

rerouting advantages

active supination