What percentage of the limb must remain to preserve normal pronosupination?

To preserve normal pronosupination, which is the ability of the forearm to rotate the palm up (supination) and down (pronation), it is generally accepted that a sufficient portion of the limb must remain intact. Research and clinical observations suggest that retaining around 60% of the limb is crucial for maintaining this important functional movement.

The reason this percentage is pivotal relates to the biomechanics of the forearm. When a significant portion of the forearm is lost, the remaining musculoskeletal structures often cannot function effectively to facilitate the rotation of the radius around the ulna, which is what allows for pronosupination. Therefore, maintaining at least 60% ensures that the necessary muscles, tendons, and structural integrity are retained, allowing for effective and functional movement.

In lower percentages, like 40% or 50%, the biomechanics may be too compromised to allow normal rotational function, leading to limitations in daily activities that require such movements. Hence, 60% is the threshold where normal pronosupination can typically be preserved. This understanding is essential for practitioners when considering surgical interventions and designing rehabilitation protocols for patients with limb loss or deformities.