United Brachial Plexus Network, Inc.

We just came back from our 1st visit with Dr. Waters...what a nice man! He really made all of us feel very comfortable. He wants to have an MRI of her shoulder done and then we'll see where to go from there. He feels that she will probably need surgery, but wants to be sure with the MRI results. She has a little more than 90 degrees overhead, but has trouble with external rotation. He discussed surgery on her shoulder and mentioned a tendon transfer. I forgot to ask a few questions maybe someone can help me with:

1. Where do they get the tendons from? (I thought it was the back of the calf, but I've also hear behind the ear)

2. If the tendons are taken from the leg, does it leave a scar?

3. What is the actual name for his surgery? He said TCH calls it a Mod Quad, which I am familiar with, but this surgery seemed different. (He mentioned Mench or something along those lines, and making the incision in the armpit)

Any info would help. We meet with Dr. Kozin next. Also, do they usually have similiar methods and views?
Thanks
Felicia, mom to Olivia 23 months LOBPI

For tendon transfers, they don't actually take tendons from other body parts (not for mod quad or like surgeries).

What they do is cut one end of a tendon, and re-route it and re-attach, so that when the muscle contracts it now functions for a different movement than what it did before.

What you are thinking of is NERVE transfers, where they take from the leg or behind the ear.

Marieke (31, LOBPI)

Thanks for clarifing for me!

My daughter had a transfer done by Dr. Waters in October of last year. She was four years old. I'm not sure if our daughters' surgeries will be exactly the same, but here goes....

He stretched Lexi's trapezius down to her deltoid, and screwed them together. This was to aid in raising her arm. He also transferred a lat and the teres major to her rotator cuff to aid in external rotation. I also asked him what the name of the surgery is, but Dr. Waters doesn't name his surgeries, per se.

As for scars, Dr. Waters does an immaculate job. We have had several medical professionals tell us that it looks like a plastic surgeon closed her up. Lexi has numerous scars now from three separate surgeries, including an extensive nerve transfer. Obviously, we would rather not have the scars on her, but we are glad that he did the work!

Following the transfer surgery, Lexi was in a spica cast for seven weeks (positioned like the statue of liberty). I don't know if your daughter would be in a cast like that or not - you would have to ask that specifically. As for that particular cast, I have a lot of information that I won't type here for time's sake. But if you do find out that she will be wearing one, I would be happy to talk to you about it via email. We just went through it all, and feel that we would love to be of assistance to others. My email address is amyclark2@yahoo.com. Good luck!

Gee sounds EXACTLY like our experience 4 years ago. We also see Dr Waters, since Ella was 2 months old. HE also wanted to do an MRI for her shoulder to decided on the secondary surgery....to let us know sooner vs later. IF you have any other specific questions please feel free to email me. Overall, from our experience with Dr Waters, we highly recommend him.

~Krista~ Connect

oops just realized that after my name it should say Connecticut, not connect....

~KRista~

That all sounds very similiar to what Dr. Waters was discussing. I digested a lot of info and can't seem to get my terms straight (or remember them for that matter!) He did say that the surgery would allow her to gain external rotation and overhead motion. He definetly said she would be in a statue of liberty cast. I will certainly be contacting you if thats the case, since I am already worried about bathing, clothes, the car seat, sleeping, etc! I am also going to make sure that when we see Dr. Kozin next week that I ask him to write things down for me!
Thanks again!
Felicia

It's me again. I forgot that you asked about Dr. Kozin. We also went to see him for a second opionion. He completely agreed with everything Dr. Waters had said, so we went back to Dr. Waters for the surgery. Their views seemed to be the same.

As for the cast after surgery, there really is not a lot to WORRY about. Plan for, sure; but you will not believe how quickly your daughter adjusts to the cast. I certainly would love to share the things we did to make her life easier (and ours), but just don't spend the time worrying about it now. I did that and found that I just wasted a lot of energy We brought her to Disney right before the surgery to take all of our minds off of it, and had a wonderful time. The whole experience really bonded our family together more, she and us and her two younger brothers.

My son had the tendon transfer surgery with Dr.Waters 5 years ago. He has a very small, barely visible scar under his arm. Justin has done great over the past 5 years. We go back the end of August for his 5 year post-op MRI. Feel free to email me if you have any questions or concern.