United Brachial Plexus Network, Inc.

Please email me with all the information you know. I am a mom of an almost 4 year old with a BPI. She may have to have these surgeries. TCH is about to preview her tape.

New to this board.

Thanks!

I have been researching the heck out of this surgery, at least all that I am able to. Most doctors will not touch it unless it is over 30 degrees and most BPI doctors agree that it does not interfere at all on a functional level until after 30 degrees. Some doctors say you will have some residual weakness and that you will lose some strength, not a lot though. Some say you can regain the strength, others say it will never have the same strength. I do know that it can accentuate the weakness of the bicep since the contracture actually aided the arm in bending and getting a jump start on things like the hand-to-mouth motion. Like, if you try to lift a weight from a straight down arm position it is much harder and takes more strength, versus already having the arm up 1/4 or 1/2 way up and then lifting it the rest of the way (if that makes any sense). Also, I have learned that it is not uncommon for the contracture to return, although it would usually be at a much smaller degree, and sometimes splinting is still needed after the surgery (but I think that is rare). Different doctors have different philosophies and unfortunately the verdict is still out, since there is no data on the outcomes yet available.

We are having some EXCELLENT results with the Dynasplint and are thinking of putting off that particular surgery. With the information I have gathered, I am just more comfortable waiting for now. I just spoke with a BPI doctor yesterday who trained with Gilbert in Paris and she said often times the contracture reaches its worse degree by the time a child is 4 and it often stays the same. She explained the process and mechanics of why that is and I wish I could remember enough to share it. I got a little lost with a few of the terms.

I know a lot of kids are having it and many are very happy with the results. I am sure they will share with you. It would be wonderful to not have to splint and if the results stand the test of time, which hopefully they will. You certainly don't want to let time pass and have the contracture get worse, so if you don't do the surgery you really might want to use a good splint with tension or keep a close eye on it. I think the worse it gets, the harder it is to repair.

Good luck with gathering info. and making decisions. They are such big and hard ones to make.