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If the elbow is flexed, the palm of the hand can not face the floor. If the elbow is at 90 degrees that is what flexion is. If you rotate the forearm, the palm will face anteriorly. If you don't, the palm will face posteriorly. The only way to have the palm face the floor is for the forearm to be extended and the forearm pronated.

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Q: What is Elbow flexed at 90 degrees rotating forearm so that palm is facing the floor?
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