Review Question - QID 219551

An 11-year-old male with GMFCS II spastic, hemiplegic cerebral palsy presents with right upper extremity contractures. He has undergone home stretching programs and botulinum injections in the past with minimal benefit since he entered adolescence. The patient states his deformity prevents him from being able to wash and brush his hair with the affected hand. On exam, the patient is unable to fully supinate his hand (Figure A) due to wrist flexion and ulnar deviation deformities. The wrist position is correctable, and assessment of Volkmann’s angle demonstrates finger flexion posturing at 25 degrees of wrist flexion. Which of the following would serve as the most appropriate treatment for this patient to provide lasting correction of his deformity?