Pronation and supination after forearm fractures in children: Reliability of visual estimation and conventional goniometry measurement

Background: Forearm fractures are common amongst children and often result in limited rotational function. In daily practice, pronation and supination of the arm are often visually estimated or measured using a conventional goniometer. The aim of this study was to compare the reliability of these two methods in paediatric patients who had previously sustained a forearm fracture. Methods: Intra- and interrater reliability of visual estimation and conventional goniometry were determined in 47 children who had previously sustained a forearm fracture. Results: Intra- and interrater reliability of visual estimation and conventional goniometry was fair to excellent, with intraclass correlation coefficients (ICCs) ranging between 0.75 and 0.94. In addition, the overall goniometer data consistently showed lower smallest detectable differences (SDDs) compared to the visual estimation data, also indicating better reliability for the goniometer method. Conclusions: A conventional goniometer is an easy, fast and reliable method to determine the pronation and supination in a child who had sustained a forearm fracture. If an uncooperative child hinders the measurement, visual estimation is a good second choice. Measurements are more reliable when repeated by the same professional. (C) 2010 Elsevier Ltd. All rights reserved.