United Brachial Plexus Network, Inc.

I have some questions for all of you:

(1) at what degree of contracture was a dynamic splint recommended ? did it help? how many degrees did the splint achieve? how long did your child wear it? what type was it? what was your/your child's experience with that particular splint? (pros and cons) was the correction permanent? if not, when did the contracture reappear ?

(2) at what degree of contracture was surgery recommended? if your child had surgery, what degree of contracture was it at AFTER surgery ? were you told to go back into a dynamic splint afterward - and to correct how many degrees? and which splint?

(3) anyone with final results? (short term and long term)

just doing some exploration and research (for Maia)
thanks for your help with this,
francine

Hay Frannie:

katie's is just that last little "oomph" that won't go and the tendon is rubbing bone and makes this horrible popping and cracking. So even though the contracture is so slight Dr. Nath wants to do the tendon lengthening and has said we can either make an elbow extension splint or use the dyna splint until then.

I realize this doesn't answer any of your questions..my point is that even with a tiny contraction ( perhaps less than 5% )Dr. Nath is telling us that she is not likely to benefit from the splint, that tricep strength would be great but it would not stop the contracture once it has started and he wants to do the surgery before permanent damage is done. yeah.

forgot--this is what he told us for katie.

Hello Francine,
My son is three and half. He has had Primary, Mod Quad, and just had Bicept Lenghtening. He lacks triceps but has good bicept motion. He deveolped a contracture about age one. We went through all kinds of splints, even serial casting. Splinting worked for a short time but then it went right back. Originally, he had about 30 degree contracture. Before his surgery in November, we got it down to about 20 degree. Surgery was recommended as the splinting was not doing its job and was prohibiting movement. Additionally, there was concern about the bone not growing properly due to the constant bent arm. My son had surgery in November. He wore an extension hard type of cast for six weeks. Then, he started therapy and we were told not to put in him any kind of brace at night. He did light ROM for six weeks, and is now just beginning to do strengthening. After the surgery, he can almost full extend his arm. I would say he has less than 5 degrees. I think that is him holding his arm slightly bent. It is now a preference to do that. I say this because, prior to surgery his arm would not move beyond a certain point. Now, his arm will passively move to full extension but he lets his arm hang slight bent. The improvement is amazing. His arm looks almost the same as the right (LBPI) and his arms look the same size now. The surgery is quite rough. He had the most pain with this one and bending his arm was very difficult. We let him bend on his own, Dr. Nath said to let him bend naturally. His PT and OT did more bending but he has not lost any function. Originally, I wanted to avoid this surgery, but I am very pleased with the results. Hope this answers some of your questions.