supination and mod quad

[Connie&Andrew]

I was wondering what people's experience is with supination and the mod quad or other surgeries. How much did supination improve with surgery? Is that one of the goals of the surgery: to increase the ability to supinate?

Thanks to anyone willing to share their experiences.

Connie

[Nicole M]

My daughter was 10 months old and had the mod quad last Oct. She could not turn her hand at all. Now she can turn it halfway and she can now clap, hold cups, and a bottle, as well as two handed toys. Hopefully she will come to the point where she can turn her palm up with more therapy. Her biggest problem was a dislocated shoulder which turned her arm inward and prevented her from supinating. It did her a lot of good.

[Donna (Colleen's Mom)]

We still have zero supination, but awesome overhead movement after mod quad.

[admin]

HI My name is jameson im 12 years old i had the mod quad when i was 10 my personal experence is that it gave me more range of motion and upward and outward motion but i lost the ability to touch my stomach making it hard to get dressed.it also dosnt provide immediate results you have to go thru lots of therapy and muscle trianing before you see some really good results and the therapy never stops but i would recomend the mod qaud any day it has changed my life

[TNT1999]

Hi, Jameson. Welcome to the board! It's nice to see you posting here. I'm sorry I don't recognize your name. Does your Mom or Dad post here too? It sounds like you have a very good understanding of the nature of your injury. I'm so glad to hear how happy you are with your surgery. Keep up the great work with your therapy and with your academics and have fun! -Tina

P.S. I have a 2 1/2 y.o. daughter, Nicole, who has a BPI from birth.

[TNT1999]

Hi, Connie. Nicole was very internally rotated before her Mod Quad last March. She did improve in external rotation slightly, which enabled her arm to be in a better position, but still not to neutral. She just had the Capsulodesis surgery last month and supination is one of the things we're hoping to improve. If not, then she might need the Pronator Teres transfer surgery at some point. So, to answer your questions, the MQ helped Nicole a bit in that area, but not much (although it certainly helped in other areas such as lifting her arm straight up much higher than before). I believe that it sometimes is one of the goals of the surgery. I would ask the potential surgeon (if you're considering surgery) exactly what the goal of increased supination would be for Andrew though since our childrens' injuries are all so different. I hope I answered your ?s. -Tina

[marymom]

I dont know how old your child is- in some cases where the child is just unbder a year or so and the biggest issue is suppination you may want to check with those who choose not to have surgery and have seen suppination come in without it- to see if you might want to consider waiting for suppination or if you think that might happen for your child- you could even ask the surgeon what the normal timeline for suppination is- I believe the surgeons told us one year but I found it personally with Max to be more like 3-and others have different timelines- Max turned 3 yesterday and is really just now (the past year)beginning to suppinate past the zero to get some good suppination in- Id say...almost hands up-it isnt something we work alot on but I was just noticing how much has come in lately- surgery free in S Florida- mary

[francine]

warning warning..... this is one issue that is VERY personal and specific for each child. Sorry Connie - even if 5 say they got it and 2 say they didn't get it, it'll not have any statistical value that will help you make a decision on the mod quad. Supination is a huge issue that can be stalled for numerous reasons. Best to get advice about this from your bpi specialist(s).

I hope this doesn't sound cold- I don't mean it to be - just trying to put the facts out there for you.

-francine

[Batchler1]

One thing to watch out for is a dislocation of the radial head in the elbow. Our son has had four surgeries - don't be alarmed because the majority of childen only require two sugeries, nerve transfer and mod quad. Because his arm was in the "statue of liberty" position, the tendon of the bicep muscle was shorter. After we began therapy, the stretching cause the radial head to be dislocated...thus the fourth surgery to put it back in place. The funny thing was that we inquired the doctors at TX Childrens in Houston about this. The response we heard was that they see the radial head dislocation in most of the bracial plex injuries. I understand that they don't treat this, but if they see it in the majority of the cases - why don't they at least warn or make parents aware to look for it? As in all of the procedures, it is time critical to get the radial head back in place.

Bill