REROUTING OF THE BICEPS BRACHII FOR PARALYTIC SUPINATION CONTRACTURE OF THE FOREARM IN TETRAPLEGIA DUE TO TRAUMA

Six tetraplegic patients (eight forearms) who had a supination contrac ture were evaluated after lengthening and rerouting of the biceps brac hii. Preoperatively, the mean range of supination and pronation of the forearm was 85 and 14 degrees, respectively. Pronation increased a me an of 75 degrees without affecting the strength of flexion or the flex ion-extension arc of motion of the elbow. The forearms that had a sati sfactory result had a mean active range of supination of 69 degrees, w hile those that had a poor result had no active supination. The mean d uration of follow-up was twenty-seven months (range, twelve to seventy -two months). The result was considered satisfactory for six limbs and unsatisfactory for two. Functional gains were made in the patients' a bility to feed and groom themselves, in their ability to tend to perso nal hygiene, and in writing and typing skills when the dominant extrem ity was treated. The results were less predictable for the non-dominan t extremity. The maximum gain in the range of motion occurred at three months and the maximum functional gain, by six months.