United Brachial Plexus Network, Inc.

Does anyone have any information about surgery specifically for supination? Dr. Armenta talked about this with us just before Colleen had her mod quad. I can't find anything on the web site about it. Thanks!

Is it the pronator / suppinator transfer? Or taking a muscle from the leg? Maybe Jocey's parents can help us out with this one.

Nicole cannot supinate yet, but we're hoping to get some supination from the Capsulodesis surgery. However, if there aren't shoulder issues as well, I don't think the Caps would be the recommended surgery simply to achieve supination. Dr. Nath told us that if Nicole doesn't get enough supination from the Caps that she might later need the Pronator Teres Transfer surgery (hopefully I'm remembering that correctly!). I'm sure if you ask Dr. Nath, he'll know. -Tina

I believe you're talking about the pronator teres muscle transfer. Natalie is scheduled for it next month. They make an incision in the upper inner forearm. I believe they then change the insertion point to allow for easier supination. I don't know about the splinting because Natalie is also having another procedure that will put her in the SOL splint. We were hoping for supination to come in after the capsuledesis this past October, but the improvement was very minimal at best. Hope this offers some useful info for you.

Thank you, yes, that is what Dr. Armenta and Dr. Nath described to us. They told us about it the day she was going for mod quad, and my mind sure wasn't retaining much that day. If anyone has had dealt with it, I would really like to know what kind of post op splinting we are looking at. I would also like to know how much supination we get from it, and do we risk losing internal rotation. Thanks again!

Hi, again Donna! When I talked to Dr. Nath about this particular surgery (Pron. Teres Trnsfr.), he told me that Nicole would be in a splint that positioned her arm straight out to the side (yikes!). Also, he did say that there might be a risk of losing some internal rotation, but that it would be a minimal loss compared to what she would gain with supination. Again, though, on both of these issues, while it's great to get input from others, Colleen's splinting and function post-op might be totally different and I think Dr. Nath will be the best source of info. for you. I will keep you all in mind though (hopefully, unless my memory fails me LOL) since this surgery is a possible one for Nicole at some point. Can't think about that too much now as we're still in the post-op splint stage from the Caps. Anyway, I hope this helps. -Tina

Our daughter, Caroline - age 6, just had the Pronator Teres Transfer and the Capsulodesis at TCH by Dr. Shenaq last week. You are right that the splinting is indeed different and they transfer tendons into the forearm.
The splint is the dynamic splint that is not done in the hospital, but a 10 minute taxi ride away, to there office by the Astro Dome. Barry and Jason are wonderful and they come in the day after surgery to take measurements and than you go to them for a fitting. Ours took about 1 1/2 hours and Caroline's arm is straight out. The splint does not fully cover her upper body as it did in the other splints. There is also more hardware on this one because you have to have the supination adjusted every two weeks. If you email me I can send you a picture of what it looks like. The other thing is you wear this splint over your clothes instead of how the other splints you wore it under your clothes.
Caroline has only been in it for a week and we are still adjusting to it. Nights are tuff. The good thing is that we are able to take a shower right away - you do not have to wait 2 weeks to get the incisions wet. It takes 2 people, one to hold her arm up and one to wash her, but she loves being in the shower and it gives her a little rest from the splint.
Good luck and feel free to email with questions.
Kathy Reilly

Tina, thank you! You have been a wealth of information. I wonder if Francine has any pictures of the splint on her site...
Hopefully Nicole will recover from the caps quickly! Good luck!
Donna

Donna,
I posted you a reply 2 days ago and I guess I hit the wrong button and you didn't get it. My daughter, Caroline - age 6, just had the Pronator Teres Surgery last week at TCh by Dr. Shenaq. Please feel free to email me and I will forward you the pictures of her in the brace - it is much different than the other splints they use at TCH for the Mod Quad and other surgeries. You wear this one over your clothes and it has alot of hardware on it. Our daughter is adjusting as well as possible and loves taking it off for some time in the shower.
Kathy