United Brachial Plexus Network, Inc.

My son is heading to the Mayo at end of March, considering tendon transfer for some shoulder rotation and fusing wrist. Have conflicting opinions on wrist fusing, I would appreciate any ones opinions and thoughts on the "wrist fusing" He is pretty active and feels it might be a detriment. thanks

Hello, I know you've seen my videos so that's what a wrist fusion will look like. For myself I'm very glad I did it. I am VERY active and having the wrist fused has really helped be a little more normal in all of my activities. While I can't predict how your son would like it, for myself, here are some pros and cons I've observed:

Pros:
Huge improvement on my balance as my wrist was no longer flopping around. It seems odd, but with my wrist always flopping around it would pull me off balance when I was walking.
Hand is "locked" in a more useful positon.......this is the most important for me. My hand is so much more useful with my wrist fused into place.
Looks better....not curled or flailing
I don't have to sleep in a brace around my forearm

Cons:
I can't bend my hand back to stretch my wrist and foream....occassionally aches from that
Sometimes just mentally weird to have a wrist I can't bend
Not as flexible so harder to maneuver into a pocket or to see the back of my hand

One thing to make sure to discuss if he decides to get a fusion is how they will position the hand. Mine is in a semi-cupped position and I believe it was positioned that way because they thought I would be able to carry more things, but because my thumb and index finger are the strongest my hand would be more useful rotated in. It would also look more natural when my arm is down. Right now it holds that cupped postion when down by my side (palm is facing out) and I woulf rather it looked more natural (palm facing thigh) I just assumed that that was how it would be positioned and ended up with the "cupped hand". I will end up getting it rotated to the natural position but it involves more surgery that could have been avoided. Hope this helps and good luck

I had my wrist fused and I wish I had gotten it done straight away, however, my first visit to Mayo wasn't until four years post injury. I had a few avulsions as well, but apparently not as many as first diagnosed because about a year and a half after my accident I woke up in the morning and my shoulder was back in its socket and a couple months after that I noticed I had some bicep flexion. Any longer and I would have had too much atrophy to even notice. It kills me to think "what if" I had made it to the mayo clinic in the beginning, but I had no insurance and so they wouldn't see me. But I did eventually have a muscle transfer where Dr. Elhasaan took my trapeze muscle and turned it into a tricep, so that I had both elbow fiexion and extension. At the same time Dr. Bishop fused my wrist. Since I had no use in my hand he fused it in what would be the "natural" position, palm down, no rotation, he just lined the bones up. Which was great, my hand had pretty much tightened up into a fist, so I could push up against things. Like Angela said, it helped with balance. It made getting dressed much easier, it helped me carry things with both arms. It didn't flop around anymore, mine isn't cupped so I have a much easier time putting my hand in pockets. Working out is much easier. And overall looks have drastically improved. It isn't so obvious I have a damaged wing. And when I lift my arm to flip a light switch or something I can do it because my wrist doesn't flop around. I don't have any Cons to speak of. I will say that it has helped my self esteem and self confidence a great deal due to the fact that it no longer flops around and advertises my disability if that helps any. And it really makes the muscle transfer I had much more effective because I have control of my whole lower arm.
Sincerely
Brandon Hubbard

Angela and Brandon, Thanks for your insight, Blairs appointment is next month (3/29/11) so we will have some time to dwell on it.