United Brachial Plexus Network, Inc.

We saw Dr. Nath Monday and he said my daughter may need a "pronator transfer" to help with her supination. Does anyone know anything about that procedure?

I won't be much help...but, Dr. Nath also suggested the pronator transfer for our son, based on video. Once we saw him in the clinic though, he decided against it. He said it's a transfer of either a pronator tendon or a pronator muscle (really sorry I can't remember which). One end is transferred (reversed) to help with supination. The pronator is a muscle or tendon which helps pronate the forearm/hand. By reversing it, it can help to supinate the forearm/hand.
That's the best I've got....And by the way, the reason he decided against it was because he felt by doing caps and getting the humerus in the correct spot, it would help with supination, and he was right. 4 months post caps, he is still able to supinate with the arm straight. He still has trouble supinating the hand only.

Ask Dr. Nath for references to patients who have had the pronator transfer done. TCH can obtain permission from the patients/families first and you can speak directly to them.

Also, don't be afraid to have Dr. Nath completely explain the procedure to you and answer any questions you have about this surgery.


Peggy

I also posted a question about this procedure awhile back but did not get a response. Our son had the caps procedure done in Aug and gained some supination but still lacks a bit, he goes just past half. Dr. Nath also suggested based on our last video that he may need the pronator teres transfer in the future. I have not spoken with anyone who has had this procedure done. Our son's main deficit right now is his inability to supinate beyond half way. Feel free to email me. I do have a new email address but do not know how to change it in the profile. It is sfrost@mfx.net Stacey

Hi there
this surgery has been carried out in the past over here in the Uk by Professor Birch and his team.
It doesn't seem to get done very often now, as far as I understand it, they have seen quite good results in some children and not so good in others. The main difference in the outcome of the surgery seems to be the age of the child, in our group we have seen some good results in children aged about 7years, who are able to co-operate with the physiotherapy regime which is quite intensive - apparently the tendon needs to practice it's new manoever and the child needs to work hard at the therapy side to re-train the tendon.
So in our experience the older the child the better the outcome.
Hope this information is helpful.
Karen

bringing this back up to the top...I recently posted about more info concerning this procedure for my 5 1/2yr old son Blake, ROBPI. He can't even supinate to neutral, one year post caps...we will be sending a new video to Nath to see if any more feedback on this...

Crystal S.