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Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 8 Issue 10

Evaluation of Surgical Treatment Disfigured Forearm Pronation and Wrist Fold Contraction - Hand in Children with Cerebral Palsy

Tuan Anh Ngo*, Man Duc Minh Phan and Manilo Ottonelo

Orthopaedic Surgeon at Orthopeadic and Rehabilitation, Vietnam

*Corresponding Author: Tuan Anh Ngo, Orthopaedic Surgeon at Orthopeadic and Rehabilitation, Vietnam.

Received: March 03, 2025; Published: September 08, 2025

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Abstract

Background: Cerebral palsy is the musculoskeletal manifestation of a nonprogressive central nervous system lesion that usually occurs due to a perinatal insult to the brain. We noted that the retraction of the wrist-hand fold, forearm pronation, and thumb closing are common upper limb deformities in cerebral palsy patients and these deformities can be partially improved by physiotherapy and surgery. However, the treatment does not have a harmonious combination between surgery, rehabilitation, postoperative care, and affordable payment. At some hospitals, the rate of surgical treatment and postoperative rehabilitation for upper limb deformities is low. This study describes the clinical characteristics of forearm pronation deformity and retraction of the wrist-hand fold and indications for surgical treatment, and it assessed and monitored the results of handling, pronation, and postoperative rehabilitation.

Methods: A prospective study was carried out in 50 cerebral palsy patients with forearm pronation deformity and retraction of the wrist-hand fold in the Orthopedics and Rehabilitation Hospital Ho Chi Minh City from 2011 to 2018. Results: One year postoperatively, two patients (4%) had a disfigured wrist fold; two patients (4%) had no improvement in hand function. Hand function after surgery increased from 3.13 to 5.38 (an increase of 2.25); 69.6% of patients still had forearm pronation deformity. No severe deformity was present in any patients; 32 (69.6%) and 10 patients (21.7%) had good and moderate points, respectively.

Conclusion: Surgery for forearm pronation deformity and retraction of the wrist- hand fold in children with cerebral palsy is easy to implement. Stretching muscle bundles from muscle units has minimal effects following fasciectomy. The direction of traction when moving seems to not change from that normally seen when transferring the extensor carpi ulnaris to the extensor carpi radialis. This is very important when selecting which tendon transfer to perform. Moreover, it does not cause weakness of the wrist fold, unlike when using the ulnar wrist fold tendon. The release of round bowed tendon points facilitates the balance of pronating muscles

Keywords: Forearm Pronation Deformity; The Retraction of Wrist-Hand Fold; Children with Cerebral Palsy

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Citation

Citation: Tuan Anh Ngo. “Evaluation of Surgical Treatment Disfigured Forearm Pronation and Wrist Fold Contraction - Hand in Children with Cerebral Palsy".Acta Scientific Orthopaedics 8.10 (2025): 04-12.

Copyright

Copyright: © 2025 Tuan Anh Ngo. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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