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In patients with Brachial Plexus Birth Palsy (BPBP) both pronation and supination deformities can happen depending on the extent of injury, pattern of recovery and the resulting muscle imbalance. The main aim of the corrective surgery is to improve function but improving appearance of the limb is also an important consideration.  Pronation posture is more important for bimanual and table top activities while the supination position is required for eating and worshiping activities in some cultures. In the limb which is being used for eating, supination restoration procedures are indicated. Supination deformity is cosmetically bad and has been termed as- “beggar's hand” or “unshakable hand”. It also places the hand in less functional position and results in disability more than that would be expected for the existing muscle power in the hand. Correction of the deformity places the hand in a cosmetic position and also improves the function of the hand.

Correction of forearm deformities in BPBP