United Brachial Plexus Network, Inc.

Hello all,

I suffered a pretty serious ladder fall 8 weeks ago in which i dislocated my shoulder complicated with a fractured humerus. Over the course of 6 weeks the movement started to come back as my rotator cuff healed.

My deltoid however is still completely atrophied with no sign of return, and i look deformed. I had an MRI taken that revealed some good news that the axillary is intact, just severely stretched. I had an EMG just this last Friday which revealed the nerve is very damaged, in fact registered a 0 on the conduction test. He said he had to turn the gain all the way up just to get a reading, the slight bit of good news here was there was still a reading, how ever faint.

I have read several good stories and bad stories on this, and some conflicting of whether to have surgery and whether to not, and if you wait to long to have surgery the nerve can die completely in which there is no hope.

I am seeing an orthopedist, but nothing is better than real life experience. I would love to hear from all of you that has had a similar experience, your course of action, and your results. And at what point should i seek out a BPI specialist or some sort of nerve surgeon. It is still early at 8 weeks, but it is my right arm and i want to make sure i can resume normal activities again one day...

Thank-you in advance for any info you can offer!

Kevin

Kevin,
EMG's although good for getting a general reading are not 100% acurate. It seems the accepted time frame for a nerve graph is within 6 mos for best results. It is NEVER too early to consult with a BPI specialist and I recommend doing this ASAP. It is important with this injury to go to someone who has the knowledge and expertise.
With Dustin we went to Mayo. He did not end up with a nerve graph and had the option of a muscle graph. After discussing what "function" he would get he has decided to wait. But, we feel very good that we had the right information from the best team of BPI drs.
It is 3 1/2 years since his accident and he is still improving. His biggest problem is using his bicepts.
Sue

Thank-you Sue for getting back to me. What did Dustin do? Did Dustin injure the larger trunk nerve that feeds the Axillary? Was it a stretch also or did it sever? Did he get a 0 reading as well on his EMG? Has his Deltoid come back? lol - sorry for all the questions

From what I have heard, a graph is what is recommended if the nerve is severed, otherwise they go in and clean out the scar tissue which impedes the axons from growing and regenerating.

I have an appt with my orhopedist surgeon on Tuesday in which I plan on asking him for a referral for a BPI specialist. I spoke to someone from the board who also went to the Mayo clinic. It is exactly what I intend to do if needed. I have heard 6 months is the window.

Thanks,
Kevin

Dustin's injury is to C4-5-6-7. It is a stretch. At about 6 mos they did go in and have a look as he wasn't getting a reading on one of them. Sorry don't remember which. When they got in there they found no avulsions so they cleared out scar tissue. His deltoids did return. It is mainly his biceps now. He was making some progess with therapy and that is why they were waiting before actually going in. He was prepped for nerve transfer but they didn't feel that was best once they got in there. His shoulder had deteriorated until it looked like skin on bones. It was also subluxed about 2 fingers. Yes his first readings on EMG were extremely low, with some 0's. When he was open in the operating room they also ran an EMG, this is the most accurate as they can see where the needles are being placed. I think he began shrugging his shoulders, as his first excersize in that area, somewhere around 10-12 weeks post accident. They thought he would never lift his arm above his head again, it's now 3 1/2 years and he can do it.
Sue