United Brachial Plexus Network, Inc.

Hello all. A private message was sent to me asking the results of my trapezius surgery. I thought others may have the same question so I am posting my experience.

Just a quick history of my journey.
1979 - age 17, ejected from a rollover car accident resulting in brachial plexus injury. Arm was completely without function and no sensation from fingers to elbow.
2009 - decided to search out alternatives to wearing a sling. Sought out and researched all options. Got out of sling by physical therapy but then had shoulder issues.
2011 - Was evaluated at Mayo (Bishop and Shin). June: had free muscle transfer from thigh to bicep for flexion; November: had trapezius transfer to eliminate shoulder sublaxation (partially dislocated shoulder) and possible side movement.
2012 - upcoming hand and finger fusion in August.

The trapezius transfer surgery wasn't as intense as the bicep. However, The recovery was rougher. I woke up from surgery in a hard body cast from below the waist to mid chest and a full arm cast with the arm in a bent position out to the side supported by a bar from my chest to forearm. Although, in reality, the cast weighs maybe 5 lbs, it felt like 50 lbs. I believe it is called an airplane cast. And, yes, it was as bad as it sounds. I was only able to tolerate it for 2 week. During that 2 weeks I visited my local post-op doctor in an effort to make adjustments but that just did not work. The alternative that was worn can be seen at http://www.braceshop.com/productcart/pc ... 55p612.htm. So the hard cast and alternate brace were worn for 8 weeks. Then this one (http://www.ottobockus.com/cps/rde/xchg/ ... 17450.html) gradually brought the arm back down for another 2-4 weeks. If you will be in a body cast, I highly recommend to stay in the area for an extra day and be sure the cast is a proper fit before going home.

Let me note, that Dr Elhassan was only able to transfer the trap muscle due to my latissum dorsi was too weak. He said he rarely transfers just 1 muscle. This is why I did not gain any side movement. However, I can support light objects under my arm. My main goal of this procedure was shoulder relief anyway.

As horrible as all the sounds, I am glad I went through with the procedure. In my personal opinion, I did not want a shoulder fusion, and this was a great alternative. My posture is much better, the discomfort in the shoulder has been eliminated, and no more sling. Just be sure to discuss the bracing with Dr. Elhassan. Everyone is different so he may go another way depending on your situation.

Currently, I'm still working through the physical therapy, mostly for the elbow flexion. It's been difficult working though the breathing and relaxation of the transferred muscle to bicep. It seems very tight most of the time. Therapy and time is improving that. My understanding, from Dr Bishop, is that the recovery time is 1-1/2 to 2 years.

The next step is, back to Mayo in August for wrist and finger fusions. The wrist fusion is to eliminate the floppy wrist. The finger fusion is to release the claw hand and position the fingers in a more natural position. Although I do not have function in the hand it will be more useful as an assist.

Hope that this has helped anyone out there considering this procedure. Dr. Elhassan was great throughout the entire ordeal. Good luck.

Pat

Did you have neuropathic pain lower in your arm (shooters) prior to your shoulder surgry? If so has it been resolved?

THANK YOU for sharing this information ,PAT! I sure learned something new from your post. Dr E is awesome. Please continue to keep us updated here.
Carolyn J
LOBPI/74

In the beginning there was phantom pain in the lower arm but over time it seems to have resided. Mostly, I had discomfort from fatigue in the shoulder over the years.

The shoulder and bicep are feeling pretty good about now. Probably because any pain/discomfort has shift to the hand. lol. Amazing how the body compensates all these surgeries.

I am now about 4 weeks post-surgery of the wrist/finger fusion. The splint hopefully will come off this Monday. Drs. Shin and Bishop fused the wrist to eliminate the floppy wrist and fused the two bones in the arm just above the wrist to eliminate the palm up position. The thumb was also fused and tendons released in the other fingers to eliminate the claw hand. Originally there were pins in each finger but all were removed after 2 weeks except the thumb to allow additional healing of the fusion. I am hopeful that Monday's followup visit allows to remove the splint that goes up around the elbow for stabilization of the fusions. If nothing else, perhaps it can be shortened while healing continues. Although I have had no movement or sensation in the hand all these years, I should be able to use it as more of an assist and cosmetically looks a heck of a lot better.