Guest,
Not sure if you're asking about Matthew or not. I have MRI films on our website you can review. They were taken 1 year post op. www.franklinfamilybpi.com, click on the capsule release link to review.
Cindy
ACR good/bad
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Re: ACR good/bad
Kate, Thank you for your post. In retrospect, I some times wonder if we should have waited for natural recovery rather than proceding with nerve grafts and mod quad. The affected arm is shorter and was weaker after each surgery. I'm thinking if the nerves and muscles weren't weakened further by the surgeries, perhaps through the therapy received,the shoulder joint wouldn't be so damaged. Now I'm wondering if a surgery for the shoulder is needed. Soooo manyyyy concernsssss. Thanks again for your post.
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Re: ACR good/bad
Cindy, I so enjoyed your website. I'm wondering if Matthew had a winging scapula, and if so, did the ACR correct that? Thank you so much for your information!
Re: ACR good/bad
Regarding CT scans before and after the ACR.
Most doctors doing this procedure are now using MRI to diagnose the need for capsule release as well as track whether or not it has been "successful". Pearl and Edgerton started out using arthrograms, but they can't be used after the joint turns from mostly cartilage to bone. They've had to spend a lot of effort establishing that arthrograms correlate with MRI scans in young children, so they can continue following the original children who had ACRs in 1999. CT scans or plain x-rays have the opposite problem - they *only* show bone, and so can miss early but significant changes in young children's shoulders which are mostly cartilage until about 5 years of age. The MRI can be continuously compared from the time the child is very young until they are fully grown. CT scans are definitely faster and less expensive, and I'm sure Shriners would use them if they felt they were adequate (since they pay out of their own non-profit budget for much of the followup of their ACRs). But they just don't work as well. There are also concerns about excessive radiation for very young children. They aren't worth it if you can't even see what you are trying to "fix"!
Our son had his shoulder x-ray'd when he was 10 months old, and if you didn't know better, you would have thought he had not developed any joint at all! It would have been the same on a CT scan, which is just a bunch of x-ray "slices" that can be viewed individually or put back together with computer to form a 3-D image. Where the shoulder joint should have been appeared as empty space in the x-ray. There was no "ball" and no "socket" to be seen! If we hadn't known better, we would've freaked!
A CT scan doesn't really show a the detail until the shoulder joint turns to bone, but once that happens the ACR would not work anyway because it relies on the bone "growing out" into the right shape again. I have the x-rays and the MRI images taken one month apart. If anyone wants to see them, email me. The difference is really quite amazing.
Kate
Most doctors doing this procedure are now using MRI to diagnose the need for capsule release as well as track whether or not it has been "successful". Pearl and Edgerton started out using arthrograms, but they can't be used after the joint turns from mostly cartilage to bone. They've had to spend a lot of effort establishing that arthrograms correlate with MRI scans in young children, so they can continue following the original children who had ACRs in 1999. CT scans or plain x-rays have the opposite problem - they *only* show bone, and so can miss early but significant changes in young children's shoulders which are mostly cartilage until about 5 years of age. The MRI can be continuously compared from the time the child is very young until they are fully grown. CT scans are definitely faster and less expensive, and I'm sure Shriners would use them if they felt they were adequate (since they pay out of their own non-profit budget for much of the followup of their ACRs). But they just don't work as well. There are also concerns about excessive radiation for very young children. They aren't worth it if you can't even see what you are trying to "fix"!
Our son had his shoulder x-ray'd when he was 10 months old, and if you didn't know better, you would have thought he had not developed any joint at all! It would have been the same on a CT scan, which is just a bunch of x-ray "slices" that can be viewed individually or put back together with computer to form a 3-D image. Where the shoulder joint should have been appeared as empty space in the x-ray. There was no "ball" and no "socket" to be seen! If we hadn't known better, we would've freaked!
A CT scan doesn't really show a the detail until the shoulder joint turns to bone, but once that happens the ACR would not work anyway because it relies on the bone "growing out" into the right shape again. I have the x-rays and the MRI images taken one month apart. If anyone wants to see them, email me. The difference is really quite amazing.
Kate
Re: ACR good/bad
guest,
I think you've described the dillemma of the "moderate injury" perfectly in your post. The closer you are to the decision point between whether or not surgery will really help, the harder it is to decide.
Unfortunately, you will just never know if any other outcome would have been better or worse for your child. Don't beat yourself up, you made the best decision you could. As long as your heart was in the right place, I know your child will love you for it.
Kate
I think you've described the dillemma of the "moderate injury" perfectly in your post. The closer you are to the decision point between whether or not surgery will really help, the harder it is to decide.
Unfortunately, you will just never know if any other outcome would have been better or worse for your child. Don't beat yourself up, you made the best decision you could. As long as your heart was in the right place, I know your child will love you for it.
Kate
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Re: ACR good/bad
Kate,
Off topic, but what you said concerns me. My doctor was questioning if I had a bad appendix and they did a CT scan. If the CT only shows bone, I hope they didn't miss anything.
Kathie
Off topic, but what you said concerns me. My doctor was questioning if I had a bad appendix and they did a CT scan. If the CT only shows bone, I hope they didn't miss anything.
Kathie
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Re: ACR good/bad
When your children had the ACR, was it the "traditional surgery" or the "arthroscopic surgery"? Does the age of the child determine which surgery will be done? Is arthroscopic only performed on adults? Thanks for any info. you can share!
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Re: ACR good/bad
Why did my son have a CT of his brain to see if there was a tumor for his vomiting when he was an infant?
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Re: ACR good/bad
I had a CTSCAN when they found a mass on my side...CTSCANS show everything.
To the next guest poster...
No, they do not only do arthroscopic on adults. My daugther had the ACR at 2 years and 4 months old and it was all arthroscopic.
To the next guest poster...
No, they do not only do arthroscopic on adults. My daugther had the ACR at 2 years and 4 months old and it was all arthroscopic.
Re: ACR good/bad
Guest,
Matthew's scapula was winging excessively prior to surgery. A while after surgery the amount of winging was significantly reduced; however it is not completely gone. We asked Dr. Kozin about the probability of scapular winging being reduced for Matthew prior to surgery. I would ask your doctor about that as it may vary depending on the child's injury.
Cindy
Matthew's scapula was winging excessively prior to surgery. A while after surgery the amount of winging was significantly reduced; however it is not completely gone. We asked Dr. Kozin about the probability of scapular winging being reduced for Matthew prior to surgery. I would ask your doctor about that as it may vary depending on the child's injury.
Cindy