Surgical correction of a supination contracture has three goals:
1. Reposition the forearm in a useful position of pronation (approximately 45 degrees).
2. Maintenance of a good passive range of pronation and supination.
3. Restoration of balance of active pronation and supination power.
The desirable positioning can be attained or maintained in almost every patient. The contractures must be released, the angulation at the distal end of the ulna (and occasionally of the radius) must be ameliorated, and the deforming force must be redirected.
Rerouting the biceps brachii was used in twenty-six patients and function was improved in all but one and there were no recurrences of deformity.