Forearm Rotation Limitations Post Trauma

presented by Ann Porretto-Loehrke, PT, DPT, CHT, COMT, CMTPT

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Why do my patients with distal radius fractures seem to have so much difficulty regaining forearm rotation? Understanding the complexity of the forearm and how distal radius fractures can have a profound effect on forearm rotation is of the utmost importance. This presentation gives an overview of the bony and ligamentous support of the proximal and distal radioulnar joints, including an in-depth look at the role of the interosseous membrane. Therapists will be presented with a systematic approach to addressing forearm rotation issues, including expected outcomes.

Meet Your Instructor

Ann Porretto-Loehrke, PT, DPT, CHT, COMT, CMTPT

Ann Porretto-Loehrke is a skilled clinician and dynamic instructor. She is the therapy manager of a large department at the Hand to Shoulder Center. Ann is a Certified Hand Therapist (CHT) and a Certified Orthopedic Manual Therapist (COMT) for treatment of the upper quadrant through the International Academy of Orthopedic Medicine (IAOM). She has extensive…

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1. Understanding the Anatomy & Kinematics of Forearm Rotation

Having an appreciation for the interosseous membrane and the interplay between the proximal and distal radioulnar joints is imperative when determining what structure is limiting forearm rotation. This chapter covers the anatomy of the forearm, including the interosseous membrane and key structures about the distal radioulnar joint, as well as the kinematics with forearm pronation and supination.

2. Distal Radioulnar Joint Assessment & Treatment

How do I know if my patient’s DRUJ is stable and in good alignment? This chapter reviews the testing of key ligamentous structures at the triangulofibrocartilage complex (TFCC) and provides guidance with appropriate treatment intervention.

3. Proximal Radioulnar Joint Assessment

Most distal radius fractures occur as a result of a fall on an outstretched hand. Increased loading of the radial head can sometimes result in stiffness at the PRUJ. This chapter covers how to manually assess the PRUJ, which can contribute to stiffness with forearm rotation.