Our 9 week old with Erbs..

[admin]

Makes a lot of sense to me Cindy. Interesting....

[katep]

My understanding of why immobilization after primary is internal rotation across the chest is because the pectoral muscles are commonly divided in order to access the brachial plexus, and this is the most pain-free position for healing. Maybe they don't divide the pecs in the UK?

Kate

[admin]

i have been in contact with erbs association they havent heard of no cast neither has the physio dept crc.i intend to ring daragh on monday for reassurance as eoghan has full movement of his head neck and arm and he is a very active baby.i feel that if its something new been tried i should have been given a choice or at least medical facts to back it up.something philip from ass. said has me thinking he said erbs is diagnosed at birth.eoghan was in icu due to broken arm and low agpar and they never discovered his erbs i had to bring him back as i found his arm limp. does this happen or is it discovered at birth. two paedraticians were present at his birth...i will ring you i will just find the area code

[Karen Hillyer]

Kate
I may be wrong here (I often am - LOL) I don't think we divide the pecs muscle over here - our incision sites seem to be somewhat different to those I have seen in the US.
Here in the Uk an incision of about 3inches is made into the neck area only - where a necklace or chain would lie and that's the only access point into the brachial plexus used.
The reason I am unsure about your incision sites in the US is that I have only ever seen 2 or 3 children's scars and those were a large zig zag cut down through the chest area - but of course there may be other surgical facilities in the US who use a different method of access than the ones I have seen.
In children in the UK who have primary surgery the incision site is always the same.

Immobilizing the arm post operatively over here has been done routinely for about 6 years now - prior to that different surgeons had different methods of post operative care.

[LeeAnne]

It really depends on the doctor over here. My daughter just had a scar in one of her neck wrinkles and a plastic surgeon was used also so now at age 7 we cant even find it. Her other scar is a straight 4 inch line under the arm pit since her nerve grafts came from the intercostal nerves instead of the leg. The reaason for that, in her case was she had ruptures of c5 and 6. c7 was the only nerve intact and avulsions of c-8, T-1 and t-2. This way we still have the sural nerves from the leg to use if more nerve grafting is ever needed for more hand function.Her pectorals were not involved in any way.

[Karen Hillyer]

That's interesting LeeAnne - you mention saving her sural nerves for future nerve grafting - is that considered possible in the US?
Over here in the Uk ( and most of Europe too, I believe) nerve grafting is never performed in children over the age of 12 months - the surgeons here tell us that they are only ever effective before 12 months has elapsed since the original injury - in fact they prefer the injury to be about 3-4 months old because that is the optimum time to be able to graft successfully, without too much scar tissue.
A child attending a clinic over here with an injury over 12 months old, would never even be offered a nerve graft.
I do find the differences between out two countries very fascinating - thanks for sharing all this info wiht me.
Karen

[Karen Hillyer]

DEBBIE
PLEASE PLEASE PLEASE
can you get your sister to e mail me at;
info@erbspalsygroup.com
I have tried EVERY combination of your phone number with the code for Dublin and I cannot get through - can you get your sister to e mail me your address and or phone number when she can?
thanks
Karen

[admin]

hi karen i will ring again on tuesday 15 at 3pm ish i dressed eoghan scar and it is vertical on his shoulder kinda where a bra strap would go. my big assumption here is that they knew prior to op c6 c7 avulsed only c5 repairable so that affected incision? maybe his incision site not been on neck didnt warrant a cast? to be honest my head is over loaded with worries thoughts etc i am trying to make sense of everything to me at the moment eoghan arm back to way it was at birth i feel months of physio have been wasted he appears to me frustrated with his lack of mobility and as a mum ifeel helpless....

[cinanina]

Hi!

My son was operated last month and I have to tell you I am really glad I did all this PT because now I am understanding what it was all for. He has all the mobility in the arm, he can't still move the biceps by his own but when we do ROM's he has all the extension. The therapist in the beggining was telling me he would cry because the movements would be painful but right now she has seen he has no pain. She is only with him since the operation. We did PT at home with each diapper change so I think he kept mobility in the arm in such a way that now it is just keeping his mobility and not really forcing anything. I am glad about this. Of course results of the nerve transfer will only be seen in some months.

As for the restaining in movement, he had his arm immobile for two weeks, it was very quick, passed in a very short while and he didn't seem at all upset about it. It was for his own good. Of course he was 3 months old then and perhaps if he was older he would feel more upset about not beeing able to move his arm.

I am very optimistic for my son's recovery. I hope everything goes right for your son Eoghan too.

And I also think all the scars will fade away in time. I sent out for Mederma from the US via internet (I am portuguese and they don't sell it here). Read about it in here and will give it a try. But if he ends up with a bit of a scar I think it will be a sexy one

[jennyinsandiego]

I'm confused- they didn't attempt repair because the nerves were avulsed?