Fig. (4) Comparison of pre- and post-operative hand-to-mouth movement in OBPI patients. Preoperative photograph of a 5.8-year old girl (A), 2-year-old boy (C), and a 4.2-year-old boy (E), demonstrating limitation of hand-to-mouth function with typical bugler’s position. Same patients, 59, 61 and 62 months after triangle tilt surgery respectively (B, D and F).