Hi Marylou
Dr Nath said he would have the top half of the arm lengthened then quite possible the lower would be ok and not need to be done. To us his upper arm looks quite good ,bigger since the Mod Quad. The lower is small and short. Also the palm is in the up position. Since the Mod Quad Frankie has gotten finger and lower arm movement but has a bad elbow contracture. He doesn't care if his arms are the same length but wants the elbow straight and his palm down so he can have more function. Dr Nath had said he needed the arm lengthened this would help the position of the hand and correct the contracture. I'm going to see Dr Cornwall at Philadelphia Children's Hospital for a second opinion if we can avoid the bone lengthening but still get the hand surgery and the elbow straight that's what Frankie wants. Dr Nath said he wouldn't do anything for the hand till the arm was lengthened and anything done to the elbow before the bone surgery would be a temporary fix. Dr Nath doesn't do the bone lengthening its a Dr Gugenheim. there is also Dr Janet Conway at the International Center for Limb lengthening in Baltimore at Sinai hospital. I can't remember where I heard this but somewhere I was told that if the child is too young the bone lengthening will have to be done more then once and if too old the growing process is slowed and the fixator has to stay on longer I don't know how true any of this is but I would get more then one opinion for sure. My big thing as I explained to Dr Nath was that if something goes wrong you can't find a doctor to treat you. After Frankie had the mod quad his dissolving stitches opened up big time his primary sent us to the hospital to see about having them restitched they said go back to the surgeon. The emergency dept would not touch him they even called Dr Nath but he was in surgery so they packed it with a wet/dry bandage and told us to get in contact with the surgeon. If there are pins in the bone and something goes wrong no one will help you they don't want to be sued so you have to get back to Texas for me that's to far to go to get help. Not that they not good doctors but after that experience I want someone in driving distance,or affiliated with a hospital I can get to quick if I need to. I hope this helps Mare
