United Brachial Plexus Network, Inc.

Francine those were wonderful questions I wish I had thought of prior to surgery. Fortunately, we were really blessed and the doctor was right on with his prediction for Cole. He would only lose a little internal rotation, but gain lots of external rotation. And once again Francine is right... I've talked to others that have chosen to do the Osteotomy for their little ones, and they all have seemed to be a bit different on where they cut the bone, and which direction the arm is rotated. It would be wonderful and much easier to research and do studies if it was a set procedure and the same for all. But it's not. So, for now we'll just having to keep asking questions and pushing for as much information as we can get.

Marnie, I know this is a tough decision. You're doing a wonderful job researching. Keep it up. Best wishes to you and your little one.

Patty

Thank you everyone so much. Dr. Nath has given me the name of a family whose daughter recently had the osteotomy and I have emailed them. I will probably be on here asking more questions about this. Dr. Nath feels as if it would be best for Peyton to have this done before his 6th birthday, I am not sure why, would anyone know the reason for this? Is it better for them to have this done earlier rather that later?

I have seen stuff out there that said this surgery worked better if done later, so go figure! It also has a high rate of late failure, ask yr doc what his results have shown after 10 or more years, this is an old surgery so there is plenty of data out there. I found the schedule of the bpi symposium held in Paris (last year? early this year??) when I was trying to research this, and this was actually one of the topics for discussion, if yr surgeon was there maybe ask what was said, there were surgeons there who have been performing this surgery for a very long time.

or you can ask Pr. Gilbert directly...his information can be found off his site www.obstetricalpalsy.net - yes he answers through email! (Isn't the internet amazing that we can reach these fabulous doctors probably easier than we can reach our primary physicians? -it always boggles my mind)

I have heard that this surgery should be done when they are older, because of all the growth that will still take place. This info. has come from a physical therapist NOT a BPI specialist. Wondering if this is totally inaccurate? What happens as our children grow, go through puberty, etc.? Does this procedure ever have to be re-done?

These are very valid questions, in the UK for a long time, a rotational osteotomy was considered to be almost the "final" surgery a child would have. Of the specialists over here, one rarely does rotational osteotomy's and the other has recently started doing many more of them. At one time the surgery was only done around 8 years, but recently the surgeon who has performed more of them has also started to perform them on younger children, I think the youngest I heard of was 14 months old.
To the best of my knowledge, there have been no studies into the long term effects of this surgery on the child. If anyone knows of any studies, I would love to read them.
I don't know if the procedure has to be re-done after puberty, I don't know of any older members of our group who have had this surgery done whilst young
I do know of a child in our group who is having the procedure re-done this year, as there was some problem with the plate in the arm not remaining fixed.
If anyone can offer any studies on the procedure, I would really love to hear from them.
I think this is a good debate, it gets all the questions into the open, and even brings up some I hadn't thought of!
bye for now
Karen