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Selected Instructional Course Lecture   |    
Reconstruction of Posttraumatic Disorders of the Forearm
Jesse B. Jupiter, MD1; Diego L. Fernandez, MD2; L. Scott Levin, MD3; Robert W. Wysocki, MD4
1 Hand and Upper Limb Service, Massachusetts General Hospital, Yawkey Building, Suite 2100, 55 Parkman Street, Boston, MA 02114. E-mail address: jjupiter1@partners.org
2 Department of Orthopaedic Surgery, University of Berne, Lindenhof Hospital, Bremgartenstrasse 19, CH-3012 Berne, Switzerland. E-mail address: diegof@bluewin.ch
3 Penn Orthopaedic Institute, Hospital of the University of Pennsylvania, 2 Silverstein, 3400 Spruce Street, Philadelphia, PA 19104. E-mail address: scott.levin@uphs.upenn.edu
4 Department of Orthopaedic Surgery, Rush University Medical Center, 1725 West Harrison, Suite 1042, Chicago, IL 60612. E-mail address: robertwysocki@mac.com
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.
Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in March 2010 in Instructional Course Lectures, Volume 59. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).
An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 Nov 01;91(11):2730-2739
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Look for this and other related articles in Instructional Course Lectures, Volume 59, which will be published by the American Academy of Orthopaedic Surgeons in March 2010:"The Management of Complex Fractures and Fracture-Dislocations of the Hand," by Jesse Jupiter, MD, Hill Hastings, MD, and John T. Capo,MDForearm rotation is the most important contribution to the rotational mobility of the upper limb1. The two-bone unit with its proximal and distal radioulnar joints, and its rotational axis connecting the centers of the two, have been viewed as a single bicondylar joint. When combined with rotational motion of the shoulder, forearm rotation permits the hand to be positioned through an entire 360° arc of motion. With the shoulder fully abducted, nearly all of the rotational motion of the upper limb occurs through the forearm1. Activities such as accepting objects in the palm of the hand require nearly full forearm supination, while many other functional tasks require some degree of pronation. It has been suggested that, in addition to rotation along the axis of the forearm articulation, the distal aspect of the ulna moves in both adduction and abduction planes with forearm rotation, although some believe that this perceived motion may be due to axial rotation of the humerus2,3.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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