Long-Term Results of Forearm Shortening and Volar Radiocarpal Capsulotomy for Wrist Flexion Deformity in Children With Amyoplasia

PurposeTo perform a long-term review of results of forearm shortening osteotomies, tenotomy, and volar wrist capsulotomy for treatment of typical wrist flexion deformities in children with the amyoplasia form of arthrogryposis, a procedure originally reported and described as “most rewarding” by Lexington Shriners Hospital for Children in 1965.MethodsA retrospective review of operating room and clinic records was done. An attempt to contact all patients produced 1 current follow-up.ResultsNine extremities in 6 patients had undergone the procedure. Of the 9 extremities, 3 subsequently underwent salvage procedures, 2 had salvage procedures recommended, and 1 had a distal forearm fracture angular malunion that compensated for the wrist flexion contracture. The charts for the patients with the 3 remaining extremities showed that at 3-year follow-up, the wrist flexion contractures had recurred.ConclusionsLong-term follow-up of the procedure shows that the initial improvement in wrist position is not maintained. This procedure is not recommended for correction of the wrist deformity in amyoplasia.Type of study/level of evidenceTherapeutic IV.