Injury of the tarsometatarsal joints is known to be very uncommon. Injury was most frequently seen as the result of high energy trauma and appear to be occuring more frequently. Early recognition was imperative, since significant long-term disability can result from inadequate treatment. We have reviewed and clinically anafysed 14 cases of tarsometatarsal Fracture-Dislocation treated at our clinic during the period frrqn March 1980 to March 1985. The following result were obtained. 1. Majority of cause of injury was traffic accidents in 10 cases(71%). 2. According to the Wilsons classification, First stage of supination was most common. 3. Associated injuried was 92%. 4. There was no significant difference between operative treatment and conservative treatment.
Accidents, Traffic ; Classification ; Joints ; Supination

The congenital radio-ulnar synostosis is a rare malformation which often completely perevents pronation and supination of the forearm. Recently, this disese has no good result by treatment including various operative techniques. The authors have experience a case of the congenital radio-ulnar synostosis, which was corrected by modified Green method and satisfactory result was obtained.
Forearm ; Methods ; Pronation ; Supination ; Synostosis

The radial head forms articulation with radial head fossa of proximal ulna and capitellum, and it ditectly contributes pronation and supination of forearm and also flexion and extension of elbow. There were debates in treatment of radial head fracture especially in displaced or communited fracture. From January 1982 to February 1992, we experienced and analysed 29 cases of radial head fracture. They were treated with conservative treatment or operative treatment according to type The results were as follows; 1. We could get better results with open reduction and internal fixation with miniscrew than radial head excision in type 11 radial head fracture. 2. There were unfavorable results of valgus instability, weakness in all cases of radial head excision.
Elbow ; Forearm ; Head ; Pronation ; Supination ; Ulna

PURPOSE: To evaluate the differences of the outcome between external fixator and external fixator supplemented with K-wire in the treatment of distal radius fractures. MATERIALS AND METHODS: Twenty-one cases which underwent external fixation (external fixation group) and 28 cases, external fixation supplemented with K-wire (external fixation with K-wire group), were analyzed. Radial length, radial inclination and volar tilt were compared in preoperative, immediate postoperative radiographs, and radiographs after removal of external fixator between two groups. And functional outcome including flexion, extension, pronation and supination of wrist were compared between two groups and wrist pain, as well. RESULT: Radial length and radial inclination in the postoperative radiographs and radiographs after removal of external fixator showed no difference between two groups, but volar tilt of external fixation group measured 2.1+/-4.2 degrees, 1.3+/-3.8 degrees and external fixation with K-wire group, 8.8+/-2.3 degrees, 8.5+/-2.4 degrees respectively, so that external fixation with K-wire group showed better reduction and maintenance. Wrist flexion and extension about postoperative 6 months measured 25.6+/-8.2 degrees, 25.1+/-10.2 degrees, respectively, in external fixation group and 42.5+/-15.2 degrees, 33.6+/-9.5 degrees in external fixation with K-wire group, so that external fixation with K-wire group showed better functional results. CONCLUSION: In the treatment of distal radius fractures, to obtain better reduction and function result, external fixations supplemented with K-wire need to be taken into consideration.
External Fixators* ; Pronation ; Radius Fractures* ; Radius* ; Supination ; Wrist

OBJECTIVE: This study was designed to investigate the effect of forearm position on the maximal isometric voluntary supination and pronation strengths and EMG activities in the related muscles. METHOD: The maximal isometric supination and pronation strengths were measured in 14 normal male subjects using Work simulator at 4 different forearm rotation position. EMG activities were simultaneously measured in supinator and biceps brachii during supination and pronator quadratus and pronator teres during pronation. RESULTS: The maximal isometric supination strength and EMG activities of biceps brachii and supinator were significantly higher as the forearm was more pronated (p<0.05). The maximal isometric pronation strength and EMG activities of pronator teres were significantly higher as the forearm was more supinated (p<0.05). The maximal isometric supination and pronation strengths were higher in the dominant side than those of the nondominant side (p<0.05) and EMG activities of pronator teres and supinator were higher in the dominant side than in the nondominant side (p<0.05). CONCLUSION: The supination and pronation strengths and EMG activities of related muscles were influenced by the forearm rotation position. Therefore the forearm position should be considered in evaluation of upper limb strength and function, and rehabilitation of upper extremity for improving strength and minimizing the overuse of supination and pronation.
Forearm* ; Humans ; Male ; Muscles* ; Pronation* ; Rehabilitation ; Supination* ; Upper Extremity

OBJECTIVE: This study was designed to investigate the effect of elbow flexion on the maximal strengths of supination, pronation, and grip which are important component of hand function. METHOD: The maximal isometric strength of supination and pronation using BTE work simulator and grip strength using hand-held dynamometer were measured in thirty normal adult subjects. Maximal voluntary contraction for 5 sec was performed at the 0, 45, and 90 degrees of elbow flexion randomly. RESULTS: 1) The maximal isometric strengths of supination and pronation were significantly higher at the 0 degree, and lower at 90 degrees of elbow flexion (p<0.05). 2) The maximal grip strength at the 0 degree of elbow flexion was significantly higher than that of 45 and 90 degrees of elbow flexion (pp<0.05). CONCLUSION: The strengths of supination, pronation, and grip were affected by the elbow flexion, which were higher in the extended position of elbow. Therefore the elbow angle should be considered and individualized treatment program should be designed in hand rehabilitation to improve strength and to minimize the incidence of overuse disorder.
Adult ; Elbow* ; Hand ; Hand Strength* ; Humans ; Incidence ; Pronation* ; Rehabilitation ; Supination*

BACKGROUND: The location of the ulnar styloid process can be confusing because the radius and the hand rotate around the ulna. The purpose of this study was to identify the absolute location of the ulnar styloid process, which is independent of forearm pronation or supination, to use it as a reference for neutral forearm rotation on lateral radiographs of the wrist. METHODS: Computed tomography (CT) images of 23 forearms taken with elbow flexion of 70° to 90° were analyzed. The axial CT images were reconstructed to be perpendicular to the distal ulnar shaft. The absolute location of the ulnar styloid process in this study was defined as the position of the ulnar styloid process on the axial plane of the ulnar head relative to the long axis of the humeral shaft with the elbow set in the position for standard lateral radiographs of the wrist. To identify in which direction the ulnar styloid is located on the axial plane of the ulnar head, the angle between “the line of humeral long axis projected on the axial plane of the ulna” and “the line passing the center of the ulnar head and the center of the ulnar styloid” was measured (ulnar styloid direction angle). To identify how volarly or dorsally the ulnar styloid should appear on the true lateral view of the wrist, the ratio of “the volar-dorsal diameter of the ulnar head” and “the distance between the volar-most aspect of the ulnar head and the center of the ulnar styloid” was calculated (ulnar styloid location ratio). RESULTS: The mean ulnar styloid direction angle was 12° dorsally. The mean ulnar styloid location ratio was 1:0.55. CONCLUSIONS: The ulnar styloid is located at nearly the ulnar-most (the opposite side of the humerus with the elbow flexed) and slightly dorsal aspects of the ulnar head on the axial plane. It should appear almost midway (55% dorsally) from the ulnar head on the standard lateral view of the wrist in neutral forearm rotation. These location references could help clinicians determine whether the forearm is in neutral or rotated position on an axial CT/magnetic resonance imaging scan or a lateral radiograph of the wrist.
Elbow ; Forearm* ; Hand ; Head ; Humerus ; Pronation ; Radius ; Supination ; Ulna ; Wrist*

The purpose of this paper is to report the rare complicated radioulnar cross union following open reduction for fractures of the forearm bones. The case was 62 years old male who complained of swelling and pain on forearm by the car accident. Roentgenogram revealed forearm bones fracture. Atpost operative 4 months, roentgenogram noted new bone crossing between radius and ulna. Excision of new bane was performed with extraction of nail and inserted chips of muscle. Post operative course was satisfactory, showing 50 degree of range of motion (20 degree supination and 30 degree pronation) from fixed pronation position.
Forearm ; Humans ; Male ; Pronation ; Radius ; Range of Motion, Articular ; Supination ; Ulna

Forearm has a unique function of supination and pronation and for the performance of such movements, normal relationship between radius and ulna is indispensable. In ulnar shaft fracture, injuries are resulted mostly from .the external forces such as direct blows or indirect forces in some cases. There are many procedures for treatment of isolated ulnar fracture, but there are still controversies concerning the best management of these fractures. The authors treated fifteen cases surgically of ulnar shaft fracture from January 1982 to December 1986 in the Deparment of Orthopedic Surgery, National-Police Hospital. The results were as follows: 1. The most common age group was twenties with twelve cases(80.0%). 2. The most common cause of injuries were direct blow(80.0%). 3, Location of fracture were middle one third with nine cases(60.6%), while proximal one third accounts for four cases (26.7%) and distal ond third for two cases(13.3%). 4. Transverse fracture were the most common type (53.3%). 5. Displacement of fractures, out of fifteen cases, were witnessed in twelve cases (80.0%) and angulation were in eleven cases(73.3%). 6. In all cases we used operative method and had good functional results.
Forearm ; Humans ; Methods ; Orthopedics ; Pronation ; Radius ; Supination ; Ulna

OBJECTIVES: The aim of this study was to evaluate the appropriate position of the forearm for measuring the BMD (Bone Mineral Density). MATERIAL & METHODS: CT scanning was performed in 21 men to determine the appropriate position for the forearm. Twenty one healthy volunteers who were without any history of operations, anomalies or trauma were enrolled. CT scanning was used to evaluate the cross sectional structures and the rotation angle on the horizontal plane of the distal radius. The rotation angle was measured by the m-view program on the PACS monitor. The DXA was used for measuring 20 dried radii of cadaveric specimens in pronation and supination with 3degrees, 5degrees, 7degrees and 10degrees of rotation respectively, including a neutral position (0degrees) to evaluate the changes of BMD according to the rotation. RESULTS: The mean rotation angle of the distal radius on the CT scan was 7degrees of supination (76%, n=16), 3.3degrees of pronation (15%, n=3), and 0degrees at the neutral position (9%, n=2), respectively. The total average rotation angle in the 21 people was 5.2degrees of supination. In the cadaveric study, the BMD of the distal radius was different according to the rotational angles. The lowest BMD was obtained in 1.4degrees of pronation. CONCLUSION: In the case of the measuring of the BMD in the forearm in a neutral position, the rotational angle of the distal radius is close to supination. Therefore, pronation is needed for the constant measurement of BMD in the forearm. We recommend measuring the lowest BMD of the distal radius at about five degrees of pronation.
Cadaver ; Forearm ; Humans ; Male ; Organothiophosphorus Compounds ; Pronation ; Radius ; Supination