Hi All-
Kinda new here, mostly a lurker. My son is almost completely recovered from a bilateral brachial plexus injury. However his physical therapist said something that I do not understand, and can't find info on-
In a nut shell: As a child who had a brachial plexus injury grows and hits a growth spurt, sometimes the elbow growth is delayed in relation to the rest of the arm. The elbow will stay in a flexed position and in these cases, the child will have the arm casted straight, in order to the let the elbow "catch up" in growth.
Has anyone ever heard of this?? Is this true??
Thanks,
Jack's mom
Delayed elbow growth in the future?
Re: Delayed elbow growth in the future?
I think your son's therapist has a confused understanding of why biceps contractures occur. She seems to think that the flexed arm posture that is common with many BPI kids is because of growth mismatch. I do not think that is the case and have not heard anything along those lines personally.
She IS right about possible treatment if a biceps contracture starts to develop. Serial casting is an effective approach to resolving fixed elbow contractures. But a better approach is to work on straightening exercises and to keep the elbow stretched out properly. A biceps contracture also is very common if the child has a fixed internal rotation contracture, and addressing the internal rotation posture can help prevent the development of a biceps contracture.
Kate
She IS right about possible treatment if a biceps contracture starts to develop. Serial casting is an effective approach to resolving fixed elbow contractures. But a better approach is to work on straightening exercises and to keep the elbow stretched out properly. A biceps contracture also is very common if the child has a fixed internal rotation contracture, and addressing the internal rotation posture can help prevent the development of a biceps contracture.
Kate
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Stephen's mom
- Posts: 6
- Joined: Mon Nov 09, 2009 5:09 pm
Re: Delayed elbow growth in the future?
Hi Jack's mom,
Very new here, but dealing with BPI for 12 years. Did not have Inet back then and was not at all educated about this condition. I think the answer is that the nerve activity does not keep up with the growth of the bone/muscle/tendon. The arm has a palsy (partial paralysis) and is unable to keep up with the growth and keep it straight at the elbow joint. I think it in my brain better then I write it, but, I have the best advice in the world; if you are given a splint for your child (you should be) to wear at night that will adjust with his growth, have him wear it religiously!!!!!
My son is 12 and it looks like the bones in his elbow joint are fixed. He has always had a contracture, and I have had splints, but did not use them faithfully. He had the release and transfer of his latissimus dori (muscle under arm brought up to be the scapula), and when we decided to deal with his contracture, it may be too late. I am in the process of seeing an elbow specialist.
This was all preventable and the therapist I had were not well educated about BPI and did not explain things in a way that said use it or loose it. When my son was injured at birth, the OB doctor was very aloof, the pediatrician was casual and figured he would be fine, we went to the Brachial Plexus Clinic in a major city (where we live) when he was 4 months old and they did not even do a nerve test. They did not tell me to keep getting him checked and did not spend any time educating me about this condition. I was clueless!! His second therapist let him go at 18 months and acted like all would be fine. We just found out when he was 11 that his scapula nerve was dead!! I would love to persue a law suit against the neurologist that misdiagnosised him and said all nerves were in tact just from physical exam and would have been forced to do so if I did not have good insurance.
I will go now. I am interested in this group because I feel I am just realizing the impact of this condition from birth.
Stephen's mom
Very new here, but dealing with BPI for 12 years. Did not have Inet back then and was not at all educated about this condition. I think the answer is that the nerve activity does not keep up with the growth of the bone/muscle/tendon. The arm has a palsy (partial paralysis) and is unable to keep up with the growth and keep it straight at the elbow joint. I think it in my brain better then I write it, but, I have the best advice in the world; if you are given a splint for your child (you should be) to wear at night that will adjust with his growth, have him wear it religiously!!!!!
My son is 12 and it looks like the bones in his elbow joint are fixed. He has always had a contracture, and I have had splints, but did not use them faithfully. He had the release and transfer of his latissimus dori (muscle under arm brought up to be the scapula), and when we decided to deal with his contracture, it may be too late. I am in the process of seeing an elbow specialist.
This was all preventable and the therapist I had were not well educated about BPI and did not explain things in a way that said use it or loose it. When my son was injured at birth, the OB doctor was very aloof, the pediatrician was casual and figured he would be fine, we went to the Brachial Plexus Clinic in a major city (where we live) when he was 4 months old and they did not even do a nerve test. They did not tell me to keep getting him checked and did not spend any time educating me about this condition. I was clueless!! His second therapist let him go at 18 months and acted like all would be fine. We just found out when he was 11 that his scapula nerve was dead!! I would love to persue a law suit against the neurologist that misdiagnosised him and said all nerves were in tact just from physical exam and would have been forced to do so if I did not have good insurance.
I will go now. I am interested in this group because I feel I am just realizing the impact of this condition from birth.
Stephen's mom
-
Stephen's mom
- Posts: 6
- Joined: Mon Nov 09, 2009 5:09 pm
Re: Delayed elbow growth in the future?
Hi Kate,
I did not mean to contradict what you said, it is just my way of thinking about it. You are right about the bicep contracture. I think my son had all of what you described. The surgery he had a year ago has been successful and he is able to supinate without compensating. He can now carry boxes with both arms!! I am afraid his elbow is going to contract more and more because he has alot of growing to do. His bones at the elbow are thicker as well. Do you have a BP kid??
Stephen's mom
I did not mean to contradict what you said, it is just my way of thinking about it. You are right about the bicep contracture. I think my son had all of what you described. The surgery he had a year ago has been successful and he is able to supinate without compensating. He can now carry boxes with both arms!! I am afraid his elbow is going to contract more and more because he has alot of growing to do. His bones at the elbow are thicker as well. Do you have a BP kid??
Stephen's mom