humeral osteotomy? sp?

[blakesmom]

my son has had primary, modquad, capsulodesis, bicep lengthening, humeral osteotomy and now will have forearm osteotomy, sometime early next year.

he is 8 years old and although it is hard that the last one didn't really help so much and I wonder how much surgery is too much, he is getting older and realizes differences in his arm and wants it to be better. I know that I don't want to let him down and will do anything that I can to help him.

He had ruptures of C5, C6, avulsion of C7 and nueroma on C8.

Crystal

[admin]

To guest,

The thing about the surgeries is that nerve grafting, nerve transfers or nerve transplants are the only surgeries that can help "power" the arm. The other surgeries are all about positioning. If the arm is not powered enough to move, then the positioning surgeries won't have the same affect as another child might have if their arm is powered more. Does this make sense?

Also, if the muscles are not innervated in the 12 to 18 month period, then they will be atrophied to the point where they may not be able to be helped with nerve work. This is why you hear about muscle transplants (like the gracillis transfer)- they will bring in a fresh muscle so that they process can start from scratch with a new muscle.

I don't know your child's situation, but ask your specialist to explain this more in the context of your own child.

Happy Holidays

[admin]

and in thinking about what I wrote above, some of the positioning surgeries actually do help power the arm if they are moving working and stronger muscles into areas where there is atrophied muscles. I had to think that through a bit.

Here's another example. Many children have muscle and tendon surgery (transfers and releases) and they seem to instantly have more range and function. My child took a year to gain the full intent of the surgery because although her muscles could now fully be manually ranged into new heights, the muscles weren't strong enough to power themselves into the new ranges. We worked on it for a whole year in therapy and what she had after a whole year was incredible when compared to what she had just following the surgery.

And also, if we didn't do the rehab therapy 4 X a week for a whole year following the surgery I truly believe that she never would have made those gains.

These are just a couple of the reasons why there are so many differences in the results the children have. I'm sure there are more.