United Brachial Plexus Network, Inc.

hello i was wondering if anyone has had this and if anyone has a photo of the splint, i was wondering if i need ot get bigger clothes and what i might need, my son jared will be having it on march 10th by dr.nath and also wondering if anyone going to be down there the same time.

I'd love to see pictures, too, (and gets tips on clothes) as there is a chance that my son may need this surgery.

Sally - if you post your email address I can send you pictures. If you want to remain anonymous then just set up a hotmail account.

Jaredsmom, I will email you pictures. The best best to begin with is just to get a couple of bigger t-shirts and then once you are home, you'll be able to see better what you will need to do. It comes down to slitting the side open and using some velcros or ties to then keep it closed. It doesn't have to get too involved. I've always gone to thrift stores for our "splint-wear" so that I don't feel too guilty about cutting and velcro and such.

Just do the pose yourself. Have both arms down at your side. Then (whatever side the bpi is on) flex the elbow until it's at waist level and supinate the palm. That's the position. You won't be able to move the arm up or move the arm at all and you won't be able to take the splint off to get a shirt underneath. Honestly - just get a couple of bigger t's and wait til you get home before you start cutting and velcro'ing.

The Triangle Tilt is different from the younger child acromioplasty in that you will not be allowed to remove the splint for six weeks- it's treated like a cast.

Thanks - my email addy is msrw06@starpower.net

I used to be able to log in, but for some reason, I can't anymore. Sorry about that - and thanks so much for the pics!!

I am interested in seeing pictures of the splint. My 9 year old may be having this surgery after we find out the results of her 3d CT Scan that she is having today. My email address is jlguess@aol.com. Thanks

I have watched the video on Dr. Nath's website regardig this surgery as it has also been recommended for my child. Does anyone know if the bones are just cut or is there a section removed? How do the bones that are left join back together since one end is higher than the other? (I'm not sure if it is the limitation of the computer animation that makes it look like this.) My child has pretty good external rotation but little internal rotation. Anyone else child in this situtation?

I really think to get the answer to these questions, you would have to ask Dr. Nath. Maybe you could write up all the questions you have for him and email them to him. He is really good at replying quickly. Then maybe you could let us know what he says.

Here is the link to the animation that shows the surgery very clearly. You have to download the media player and the flash player in order for it to work.
http://www.drnathbrachialplexus.com/inj ... _after.asp

http://www.drnathbrachialplexus.com/sur ... e_tilt.asp
this page has the description of the surgery and another animation, too

Bone is not removed, it is just cut. It is a double osteotomy. Osteotomy of the clavicle and osteotomy of the acromion. They are reset in such a way that it changes the position of the scapula.

I forgot to write about the bones healing. I had just asked him about this a couple of days ago and he told me that the bones actually do grow together in one piece. They shave the ends down so that they are not sharp. But because they do this in children under the age of 12 it heals together nicely and straight.

Well here is how he answered me:

"The bones heal together through a fusion-like process in which bony tunnels connect and stabilize the newly fractured fragments. Splinting of the arm allows this fusion to occur without interruption and is therefore critical to the success of the surgery. Bony edges are not of concern in children because 1) the sharp edges of the bone are surgically trimmed and 2) the soft character of the clavicle and scapula in children allows for a more rounded and successful fusion of the fragments. For this reason, adults are not suitable candidates for the triangle tilt procedure."

Has Dr Nath had orthopedic training or does he have an ortho trained Dr do the surgeries for him?