Six tetraplegic patients (eight forearms) who had a supination
contracture were evaluated after lengthening and rerouting of the biceps
brachii. Preoperatively, the mean range of supination and pronation of the
forearm was 85 and 14 degrees, respectively. Pronation increased a mean of
75 degrees without affecting the strength of flexion or the
flexion-extension arc of motion of the elbow. The forearms that had a
satisfactory result had a mean active range of supination of 69 degrees,
while those that had a poor result had no active supination. The mean
duration 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' ability
to feed and groom themselves, in their ability to tend to personal hygiene,
and in writing and typing skills when the dominant extremity was treated.
The results were less predictable for the non-dominant extremity. The
maximum gain in the range of motion occurred at three months and the
maximum functional gain, by six months.