TRANSPOSITION OF THE BICIPITAL TUBEROSITY FOR TREATMENT OF FIXED SUPINATION CONTRACTURE IN OBSTETRIC BRACHIAL-PLEXUS LESIONS

In nine patients with obstetric brachial plexus lesions (Klumpke type) , an impingement of the bicipital tuberosity on the ulna was the main cause for the forearm and hand to be fixed in supination. A surgical t echnique using reinsertion of the biceps tendon on the bicipital tuber osity is described in detail. It has substantially improved all patien ts. After a mean follow-up of 29.4 months the hand was in a more funct ional position than preoperatively in all patients. In seven cases pro nation could be increased by contraction of the biceps muscle. By rela xing the biceps muscle and by contraction of the supinator muscle a li mited active supination was possible in six cases.