United Brachial Plexus Network, Inc.

Hi. My daughter, Madison, is 5 she has rbpi. This past year I have noticed her hand is slightly bending sideways at her wrist, basically her hand is pointing outwards. Has this happen to anyone else? We where at physio today and she noticed that it is getting worse. She brought in the OT to have a look to see if she could make a split to try and correct it. Physio also noticed that there is a space between her wrist and her hand on the inside of her wrist, kind of like her hand is pulling away from her wrist on the inside. anyways the OT's are at a loss of how to make the split, because if they put a bar in the split, then she will be unable to bend her wrist back and forth, which means no weight bearing. Any ideas would be great. I would love to pass them on to the OT's.

Melissa

I have noticed something similar with my child, but no one really notices it like I do. I guess it will have to get more severe before anyone pays attention to it. I have also wondered what the heck it is and what is going on. In my child's case, I think it may have something to do with compensation and by curing the wrist some, he can better position his hand to use it. But it almost looks like a little lump is forming and that the bone is growing weird but maybe it is just how he is positioning it. Wish I could help you, sorry.

Kari, are you out there? She has just started a great resource for therapists of bpi children, where they can communicate through group email, ask questions, share ideas, etc. It would be a great resource to get your therapists in. Does anyone have the information?

Hi Melissa - it's so hard to actually understand what Maddy's hand is doing from a description. But if you do a video tape of her hand and send it to a bpi center, I'm sure that the OT from the center would be glad to give your OT advice on how to splint it. Also - maybe the doc should give a look at it too - why is this changing at age 5?

Good luck!
-francine

Yes, it seems to me that it is pretty normal for my injury.
I'm 37, OBPI. When I was around 12 my hand began to 'draw' outward.(left BPI, palm toward the ground)
That was a big concern for my Mom, Dad and the Doc.
The Doc. said it was the muscle that was not 'as effected' by the injury pulling against the muscle that was 'more effected'.
My solution was and has been to exercise it right when I wake-up (I find that muscles are not as tense in the morning).
I lay my arm on a flat surface(kitchen table)and hold it with my right hand, then(without moving my elbow)I straighten my wrist as much as possible, relax and repeat. I usually do this for 5 min.s(while I read, drink coffee, and catch the news).
After a while you'll find that during the day, as you notice it, you'll be able to 'check' your daughter on it and make her straighten her wrist, then she'll start to 'check' herself as she gets older.
I also make myself straighten my arm as it begins to 'chicken wing' as I like to call it.(draw up, toward the chest)
My Dad came up with the exercise because, at the time, not much was none about BPI.
If anything I've said helps, let me know or if you have anymore questions feel free to write me at lilfeat@wnclink.com
As I've said, I'm 37 and for many years people really have to watch to notice my handi-cap...but it takes practice.
Good Luck

This hasn't happened with my daughter, but Kineso taped jumped to mind when you describe it. It would help her to pull her hand back in place, but still allow flexiblity for weight bearing activities. Just a thought.

Same thing has happened to my daughter. We have discussed tendon transfers to assist with this along with other muscle weakness's. It is probably because the extensors are much stronger than the flexor muscles in the hand. Just curious, does your childs hand also pull back at the wrist?

I may be WAY wrong and you need to ask your doctor but it seems to me that this would happen if the forearm bones grow at different rates....I believe I saw osteotomy pictures....to repair this...I will look for the link.
My son has a definate difference in growth rates and that caused him problems in his elbow...I don't see why it wouldn't happen in the wrist too depending on what nerves were damaged and what grew back.
T.

Thank you everyone for you responses. I am unable to have her doctor as he is a 20 hour drive from where we live. None of the doctors around here know anything about this injury. The Physio theripists and OT's are just learning of this type of injury to. My daughter was the first child they seen with BPI in our home town.

I will try the exercise that where mentioned in the post and see how things go. I am also going to request that she gets an x-ray done on her wraist as well, so we know exactly what is going on with the bones and tendons. This space there just doesn't seem natural.

In response to her wraist bending backwards, she tends to keep her wraist bend upwards so it is in a better position for her to use it for picking objects up and using her hand for everyday activies.

Thanks again everyone
Melissa