United Brachial Plexus Network, Inc.

check this out... deltoid tuberosity (the lower portion of the deltoid and where it attaches to the bone)

http://en.wikipedia.org/wiki/Image:Gray207.png

about the young woman...her scar shows that it was cut directly in the middle...but where is her insertion? don't know..

I called Dr. Davino's office with a list of questions for Maia and when I get the answers I'll post.

The young woman does not believe she was dislocated, however there was acromion impingement (from overgrowth) and that is why her movement is not as pure as it could be)

If you don't mind me asking, what surgery did Mia have early on? I'm asking because the video I saw of her is incredible and gave me hope for my four month old that just had a nerve graft and transfer due to an avulsion.

that video of the 18 year old? that wasn't Maia...

Maia is 9... here's a video of her
http://www.youtube.com/watch?v=WO0veXG42NQ

she's the one in the middle that claps with the elbow up

Even though Maia's arm is oddly positioned and her range and function is restricted, she's having a great time at life! My hope for her is that her fun and her exciting life continues....whether her arm works or not.

Paula,

As I recall, Aaron had caps along with acromioplasty (and something to do with the clavicle)? Has Dr. Nath explained how this next recommended surgery differs from what he's already done in there (ie acromioplasty)?


Kate

Wow Francine what a difference from what a BPI "looks" like. That video is amazing! Thanks for sharing that. Marnie those pics, I don't know what to say. Kate, I haven't had a chance to talk to Dr Nath. When my husband took Aaron to Houston i wasnt able to go, damn job of mine, so Dr Nath was kind enough to call me on my cell and talk to me for a while after the appointment. I wasn't in the right frame of mind to ask him anything, you would think that after hearing 4 prior times the words "he needs surgery" that we would be used to it-sheesh yeah right. I will have to call him and ask him what exactly will be done and how will it differ from the CAPS that he had 2 yrs ago.

All I can say is WOW! Ashley is almost 12 and at her last doc appointment Dr. Rielly recommended the HO. We are unsure of whether to do it or not. Ashley wants to do it so that is a start. ( She keloid scars badly is the downside) I love all the information you have all posted and will spend some time going through it. I can say that we were told that the HO could happen at any time so not to hurry into it.

Great topic !

Lenni

pertaining to the video of the older girl - can someone please explain to me how a humeral osteotomy can give better overhead range. Her video was impressive. It would be beneficial to see her "before" function. Did she have prior surgeries? Sorry if this was already mentioned and I missed it.

Dr. Waters has a study out there that shows equal improvements in overhead range for tendon transfers (such as "Mod Quad") and humeral osteotomy.

Basically, the deltoids cannot function properly when the arm in severely internally rotated. If you do an osteotomy with the cut above where the deltoid inserts (I'm not sure who does *not* do it this way) the derotation from the osteotomy also rotates the deltoids into a more functional position. So yes, osteotomy can greatly improve overhead function along with giving external rotation. Derotating the humerus probably even allows the posterior deltoids to kick in better, enabling some active external rotation as well.

Kate

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