United Brachial Plexus Network, Inc.

Has anyone's child had this after Triangle Tilt? What was the need and outcome? Thanks - Camille B.

Anyone? Please help!

Natalie has had different aspects of the TT over the years, but it was before the actual TT was devoloped. Just 2 weeks ago, she had the scapular ostectomy along with Botox. The S.O. was recommended because of scaular elevation and rotation. The goal is that there will be cosmetic improvement as well as functional improvement. The procedure along with the Botox should allow for better results from strengthening exercises and TES. We're still dealing with some swelling and discomfort so it's too soon to judge the outcome.

Stacy, thanks for posting. My 4 year old daughter will have this surgery soon. How did your child do with the surgery? Pain? Recovery? Any information would help me. Thank you.

Natalie has had 8 surgeries, so she deals with it a lot better than most kids her age. She's very knowledgeable and requires a lot of information from the doctors and nurses. This was our first time at Hermann, and I was impressed with both the hospital and staff. Dr. Nath gave us the option of staying overnight, but I knew everyone would rest better if we went back to the hotel. Anytime bone is involved, there is more pain, and I've seen that with both the acromioplasty and the ostectomy. We're 3 1/2 weeks post op, and she still takes pain meds at night. Part of that is due to the gunslinger splint she's in. (OS doesn't usually require splinting, but we decided to go ahead with it to help with the Botox) She went back to massage last week and we've done some stretching and ROM at home, but will resume formal PT this week. The incision is healing beautifully and doesn't seem to be too sensitive. Let me know if I can offer any more info. Good luck!

Was there a great deal of pain after the surgery or was it mild? Where did she get the botox? How long is she in the cast? Please tell me everything and anything you can think of, our surgery is coming up.

It's hard to gauge Natalie's pain. I think age and experience has so much to do with how they react. She was really hurting in recovery and continued to throughout that first day. The whole splinting procedure is never fun so the following day was pretty rough also. She has definitely improved with each passing day, but the thing I've noticed is the need for pain relief/medication much longer-especially at night. I know that part of it is due to the splint, but she still complains of hurting in the evening even before we put it on. I put a warm rice bag on her neck, shoulder and upper back in the evening then around the middle of her arm in the morning when the splint comes off. This seems to ease some of her discomfort and loosen her up so we can stretch even more.

The botox was done by Dr. Kumar--he's part of Nath's team. He did a surface EMG two days before surgery, and because of the obvious contractures, we decided on Botox. The effects will last about 3 months at which time we'll re-evaluate with the possibility of doing another round of injections. Most likely, she'll be in the night splint for about 6 months.

I'm in the process of re-configuring an Ark brace that was made for her last year to help hold her shoulders back and straighten her posture. I'm also waiting to hear back from Dr. Nath so that I can re-start her night time TES.