Arm rotated medially with supination

Description: Patients who have suffered obstetric brachial plexus injury (OBPI) have a high incidence of musculoskeletal complications stemming from the initial nerve injury. The presence of muscle imbalances and contractures leads to typical bony changes affecting the shoulder, including the SHEAR (Scapular Hypoplasia, Elevation and Rotation) deformity. The SHEAR deformity commonly occurs in conjunction with Medial Rotation Contracture (MRC) of the arm. OBPI also causes muscle imbalances at the level of the forearm, that lead to a fixed supination deformity (SD) in a small number of patients. Both MRC and SD will cause severe functional limitations without surgical intervention.
BMC Musculoskelet Disord. 2009; 10: 32. Published online 2009 March 16. Arm rotated medially with supination – the ARMS variant: description of its surgical correction Rahul K Nath,1 Chandra Somasundaram,1 Sonya E Melcher,1 Meera Bala,1 and Melissa J Wentz (full text)