OBJECTIVE: Depending on its axis, pronation varies from the radius rotation around the steady ulna to the reciprocal adduction of the radius and abduction of the ulna. While there is no question that pronator teres is a central pronation agonist, anconeus\'s role is not settled. The current investigation comparing palpation and ultrasonography in these two muscles during pronation along the axis capitulum-second digit evolved from a serendipitous finding in a clinical anatomy seminar.
METHODS: Single-hand palpation and two-transducer ultrasonography over anconeus and pronator teres were used on ten normal subjects to investigate their contraction during pronation around the capitulum-second digit axis. These studies were done independently and blind to the results of the other. The statistical analysis between palpation and ultrasonography was performed with Cohen\'s kappa coefficient and the χ2 test.
RESULTS: On palpation, on resisted full pronation, anconeus contracted in 8/10 subjects and pronator teres in 10/10 subjects. Without resistance, the corresponding ratios were 5/10 and 9/10. On two-transducer ultrasonography, the comparable ratios were 7/10 and 10/10, and 3/10 and 10/10. A fair concordance (Cohen\'s kappa = 0.21) between palpation and ultrasonography in detecting the simultaneous status of anconeus and pronator teres during resisted full pronation. Anatomic dissection illustrated the elements involved.
CONCLUSIONS: Plain palpation confirmed by ultrasonography showed the simultaneous contraction of anconeus and pronator teres during resisted pronation in most of the studied subjects. The study suggests that palpation can be helpful in directly studying muscle activity during movement.

UNASSIGNED: The traditional scarf osteotomy (TSO) has limited ability to correct the first metatarsal pronation. A novel modification that we refer to as a \"dovetailed notch scarf osteotomy\" (DNSO) has been developed to enhance the ability to correct coronal plane pronation. The study aimed to observe and compare TSO to DNSO in the treatment of moderate to severe hallux valgus deformity.
UNASSIGNED: This retrospective study included 78 feet that had a TSO and 105 feet that had a DNSO. Minimum follow-up was 24 months. Weightbearing computed tomography (WBCT) and weightbearing anterior-posterior (AP) radiographs were taken preoperatively and at the last follow-up. We measured the intermetatarsal angle (IMA), hallux valgus angle, distal metatarsal articular surface angle on AP radiographs and first metatarsal coronal pronation angle (α angle), tibial sesamoid coronal grading, and first metatarsal length on WBCT. Clinical assessment was done using visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale, Foot and Ankle Ability Measure (FAAM), and the 36-Item Short Form Health Survey (SF-36). The occurrence of postoperative complications was also documented.
UNASSIGNED: The DNSO group exhibited a significantly higher correction amount of α angle and IMA (14.3 ± 9.9 and 10.3 ± 4.6 degrees) than the TSO group (8.6 ± 5.9 and 5.4 ± 5.9 degrees) during the final follow-up assessment (P < .05).The DNSO group (10.1 [8.0-12.0] degrees and 4.8 [3.9-5.6] degrees) demonstrated significantly smaller α angle and IMA compared with the TSO group (4.8 [3.9-5.6] degrees and 9.5 [7.5-11.5] degrees) at 24 months postsurgery (P < .05). The postoperative FAAM activities of daily living and SF-36 physical functioning scores were significantly higher in the DNSO group (97.2 ± 3.3 and 95.7 ± 4.4 points) compared with the TSO group (92.3 ± 3.3 and 87.7 ± 8.7 points) (P < .05). Additionally, hallux varus occurred in 1 case in the DNSO group, whereas 4 cases were observed in the TSO group.
UNASSIGNED: Two osteotomy methods can effectively correct moderate to severe hallux valgus deformity. Compared with the TSO, the DNSO has stronger correction ability. The most crucial aspect lies in its controllability when correcting first metatarsal pronation and addressing IMA.
UNASSIGNED: Level III, retrospective comparative study.

This study seeks to explore the correlation between cortical activation and the Infinity Walk pattern, examining how the influence of foot overpronation and footwear may impact motor control. Functional near-infrared spectroscopy (fNIRS), a portable and user-friendly neuroimaging technique, was used to measure hemodynamical changes in six individuals with non-critical pronation degrees. Participants perform the Infinity Walk under various footwear conditions while wearing an fNIRS portable imaging device. Results indicate a consistent hemodynamic pattern in both hemispheres during the Infinity Walk, with no significant differences observed across subjects and footwear conditions in the prefrontal cortex (PFC), pre-motor area, the supplementary motor cortex (PMA & SMC), the primary motor cortex (PMC), and Wernicke\'s area (WA). The impact of pronation and footwear on motor control remains inconclusive due to inconsistent hemodynamic patterns. Notably, the activation patterns in Broca\'s area (BA) and the temporal gyrus (TG) differ significantly from other brain regions. The balanced hemodynamic responses in the bilateral hemispheres may be attributed to the Infinity Walk\'s inherent walking pattern. These findings indicate a need for further investigation into the Infinity Walk to examine the similarities and distinctions in activation patterns within specific brain regions. Additionally, the impact of pronation necessitates more substantial experimental research to establish a correlation between pronation and cortical hemodynamics.

OBJECTIVE: To evaluate the effect of an induced synostosis with a screw on pronation and supination in cats.
METHODS: Ex vivo biomechanical study.
METHODS: A total of 58 feline forelimbs.
METHODS: A total of 58 cadaveric feline thoracic limbs were mounted on a custom-built jig with the elbow and carpus flexed at a 90° angle. To exclude any orthopedic disease, radiographs of the forelimbs were performed prior to the mechanical tests. Radioulnar synostosis was imitated with a 2 mm cortical screw through the radius into the ulna in the proximal (Group P; n = 54), middle (Group M; n = 52), and distal (Group D; n = 53) radial diaphysis. The angles of pronation and supination were recorded after manually applying a two-finger tight rotational force to the metacarpus. Rotational tests were performed without a screw (Group N) and with a screw in each of the aforementioned positions. Pairwise comparisons between the groups were performed based on their angles of rotation with a paired t-test with the Benjamini-Hochberg procedure and a mixed model ANOVA.
RESULTS: Mean angles of rotation decreased between Group N (129.5 ± 15.9°) and all groups with imitated radioulnar synostosis to a mean angle of 37.5 ± 14.5° (p < .0001). Mean angles of rotation did not differ between the groups with imitated radioulnar synostosis.
CONCLUSIONS: Induced radioulnar synostosis decreases antebrachial rotation by more than two-thirds, regardless of location.
CONCLUSIONS: Implants fixating the radius to the ulna should be avoided in cats, regardless where they are located along the radial diaphysis.

Non-invasive ventilation (NIV) treatment combined with pronation in patients with COVID-19 respiratory failure has been shown to be effective in improving respiratory function and better patient outcomes. These patients may experience discomfort or anxiety that may reduce adherence to treatment.
The aim of this study was to explore and describe the subjective experiences of patients undergoing helmet NIV and pronation during hospitalisation for COVID-19 respiratory failure, with a focus on the elements of care and strategies adopted by patients that enabled good adaptation to treatments.
A qualitative descriptive study, using face-to-face interviews, was carried out with a purposeful sample of 20 participants discharged from a pulmonary intensive care unit who underwent helmet continuous positive airway pressure and pronation during hospitalisation for COVID-19.
Content analysis of the transcripts revealed feelings and experiences related to illness and treatments, strategies for managing one\'s own negative thoughts, and practical strategies of one\'s own and healthcare workers to facilitate adaptation to pronation and helmet. Experience was reflected in five major topics related to specific time points and settings: feelings and experiences, helmet and pronation: heavy but beneficial, positive thinking strategies, patients\' practical strategies, support of healthcare professionals (HCPs).
This study may be useful to HCPs to improve the quality and appropriateness of care they provide.

Several studies have indicated that Camitz transfer for severe carpal tunnel does not adequately restore thumb opposition. The aim of this study was to determine whether modification of the distal insertion of the transferred palmaris longus tendon could provide more effective opposition. We used 12 fresh-frozen upper extremity specimens. For spatial analysis, we used a three-dimensional motion-tracking device. At 0 N and 5 N of traction force, the pronation angle was significantly larger for the modified procedure than for the conventional procedure. There was no significant difference in the palmar abduction angle between the two groups. The modified palmaris longus tendon insertion on the ulnar side of the thumb metacarpophalangeal joint provides more effective thumb pronation than conventional Camitz opponensplasty in a cadaver model.    .

Length change in the distal oblique band during forearm rotation was measured using four-dimensional CT in seven volunteers. There was no significant change in length, which provides more theoretical support for distal oblique band reinforcement for treatment of instability of the distal radioulnar joint.

(1) Background: This study focusses on establishing the relationship between quality of movement (based on the functional movement screen, or FMS) and foot posture (based on the foot posture index, or FPI-6). We hypothesised that a poor FMS test score may be derived from the foot position in the space measured by FPI-6. (2) Methods: a quasi-experimental and cross-sectional study was designed to analyse foot posture in 30 healthy football players, using the foot posture index and the functional movement screen. (3) Results: No significant relationships were found between movement quality and foot posture. Poor movement quality is present in more than half of all foot positions, supination, pronation, and neutral. Good quality seems to be more associated with a neutral foot position (23.3%) and supinated (16.6%) than a pronated foot position (6.6%). (4) Conclusions: this study found no relationship between the two tests; therefore, we cannot demonstrate that foot posture is relevant in the quality of the movement of the football players studied.

UNASSIGNED: The aim of this study was to determine the ideal forearm position that allows maximum upper-limb function. In certain congenital/acquired upper-limb disorders, the management boils down to sacrificing rotatory movements of the forearm. The position of fusion that facilitates maximum upper-limb function is a topic of debate and is decided upon by personal preferences and assumptions. Although the literature has many level five evidence reports, there is a lack of well-designed research to answer the same question and we intended to study it both in dominant and non-dominant limbs.
UNASSIGNED: 15 healthy adolescent volunteers were fitted with a custom adjustable brace that simulated forearm arthrodesis in five rotatory positions. They were asked to carry out a series of activities as per Sollerman\'s hand function test, and each activity was scored using the standardized scoring system. The test was carried out with the brace fitted first in the dominant side, followed by the non-dominant side, and finally in both the upper limbs together.
UNASSIGNED: We found that the mid-prone position allowed for the best function overall in both dominant and non-dominant upper limbs, and if both upper limbs required simultaneous fusion, our results suggest that fixing the dominant side in mid-prone and non-dominant side in 45° supination would be ideal.
UNASSIGNED: For unilateral forearm arthrodesis, the ideal position of fusion is the same irrespective of the dominance of the limb, whereas, for bilateral arthrodesis, limb dominance is to be taken into consideration.
UNASSIGNED: Level III quasi-experimental study.

UNASSIGNED: To review the radiographic manifestation and clinical appearance of children with congenital radioulnar synostosis (CRUS) retrospectively.
UNASSIGNED: Retrospective cohort study of children with CRUS from multiple medical centers.
UNASSIGNED: A total of 329 patients (male 259, female 70) with an average age of 5.4 years (0.5-16 years old), were included in this study. In particular, 145 patients (145/329, 44.1%) demonstrated bilateral involvement, and 184 patients (left 123, right 61) demonstrated unilateral involvement. As for Clear and Omery (C&O) classification, most patients belonged to Type III, and then followed by Type IV. As for Chinese Multi-center Pediatric Orthopedic Study Group (CMPOS) classification, most patients belonged to Type III, and then followed by Type II and Type I. In C&O Type III, 92.03% patients demonstrated severe pronation. According to CMPOS classification, 92.98% Type I patients demonstrated neutral to mild pronation, 72.17% Type II patients demonstrated moderate pronation, and 92.03% Type III patients demonstrated severe pronation. The age distribution showed no significant difference between C&O Type II and IV (P = 0.96); the pronation ankylosis severity showed no significant difference between C&O Type II and IV (P = 0.387).
UNASSIGNED: Although CRUS is a rare forearm deformity, there are certain relation between radiographic manifestation and clinical forearm functional restriction. CRUS patients of C&O or CMPOS Type III classification might suffer severe pronation deformity and warrant early intervention.