United Brachial Plexus Network, Inc.

hey my accident was 8/6/02 i avulsed c5 c6 c7 and streched t1 c8 had surgery 1/13/03 intercostal nerve graft to bicep trapezious nerve transfer to shoulder just know starting to see some changes i can feel my shoulder doing things it wouldnt do before but its still not strong enough to do anything with but i can see a change

My injury..... avulsed C5&6 streched C7 & T1.

Courtney,

Before your second surgery, could you bend at the elbow when your arm was lying on a table???

No I have no biceps at all and very weak triceps. Dr. Nath said that he has had a good success rate with this surgery so I am hoping for the best. My head still knows how to do it but the muscle wont listen at all, not yet. Ina another month or so hopefully we will see something.

Courtney, wasn't your bicep found to be firing and innervated, following the first graft, just not yet actually moving? Or was that someone else....

One thing to remember is that some people's injury recovers so quickly they never even reach a message board, and many of those who post saying they have just been injured but can move their fingers or other parts of the arm disappear, I'm assuming those people recovered fully. The people with mild injuries don't hang around, why would they... Have you ever woken up in the night with a 'dead arm' ? (Before the bpi I mean lol now it happens EVERY night!) You can't feel it and it just hangs there, then it gets severe pins and needles, then it gradually gets better, all in about a minute. That's probably as mild a peripheral nerve injury as you'd get, and they come in degrees from that mild to what some of us have....23 years and mines still not woken up! Those pins and needles have been firing for a while... One of my avulsions was probably incomplete as I got elbow flexion and shoulder shrug back spontaneously over 2 years post accident. It might even be a trick movement from back muscles rather than biceps proper, but it's no functional use to me without my hand and I'm still preparing myself and the family for amputation.
Complete avulsions are a bit different though....especially lower root avulsions C7,C8,T1. The length of arm the grafts have to grow down in adults makes it a bit dodgy, altho some bpi docs are now recommending surgery as soon as other injuries permit where avulsions are suspected, sometimes within hours, maybe those lower avulsions will respond to this. Here's hoping...

Jen,
After my first surgery there was nothing at all in my biceps. Just with in the last 6 or 8 months have they begun to "fire" so I guess you could say that before the second surgery my biceps were firing but not strong enough to do anything. Maybe I was a bit unspecific, thanks for helping me clarify Jen!

Hiya Courtney...just wanted to say that it is normally around 8-9 months that anyone having a nerve graft can expect to feel the first flickers of reinnervation. It's a slow process because the nerve grows so slowly and has so far to go in an adult. In my case, my intercostal nerve grafts took around 9 months to reach the muscle...after that it just got stronger and stronger. I can now bend my arm pretty strongly.

Liz

I have a question... in addition to the degree of motion you get after surgery, how much strength do you also see? I'm not having much luck getting anything specific from doctors.

Thanks,

Ellen

It depends somewhat on the amount of atrophy...it's why a nerve graft, as opposed to a muscle or tendon transfer is usually done around 3-4 months post accident, sometimes up to 6-7 months. The later this surgery is done, presumably the less strength returns.

It seems reasonable to take into account fitness and strength levels at the time of the accident. Someone who is young fit and healthy will probably regain more strength in a re-innervated muscle than someonme whose only excercise was lifting pints. Guess which category I belong in!

Liz B :0)