United Brachial Plexus Network, Inc.

I know several of you have this experience. My daughter's BPI arm is shorter than her normal arm. Since we haven't been back to see the surgeon yet(Fe. 25) I don't know what this is called for. Will she have to have surgery on her muscles? Are there any exercises that you could do other than ROM's? Can they take care of this in one surgery? I am not sure if/ what type of surgery she would be having. I would rather know all of my options before hand.

Thank you,
Tracey Alexyss's mom

Hi, Tracey. My daughter's left (BP) arm is shorter than her right too. As far as surgery, I believe there is a bone lengthening procedure that can be done at some point, but I'm not too familiar with it. I think that most people here, myself included, wouldn't consider this type of surgery though b/c it is purely cosmetic and our children have to go through so much other treatment (surgery, therapy, estim, etc.). I don't think a doctor would likely perform the surgery though until your daughter was old enough to meaningfully decide for herself if she wanted it done. How old is your daughter? I know that the adults with BPIs have also discussed this and I don't know of any on the adult boards who have had the surgery. Most just deal with the difference.

It is my understanding that even with lots of therapy, you won't achieve a length equal to the other arm. However, therapy is still very beneficial in helping to prevent further difference. I believe that the best type of therapy exercises are any form of weight bearing -- crawling, side-sitting, crawling up the stairs, lying on tummy on elbows, standing up and leaning the hands onto a table, using an exercise wheel (ab roller type of device), etc. etc. Bone growth is stimulated by muscle movement, so any movement will be beneficial. I hope this helps.

-Tina

Tina,
Thanks. My daughter is 5 months old. We will wait and see.

I agree with Louise- you need to have the cooperation and awareness of the patient for such an extreme surgery that would be required simply to lengthen the bone- and yes I believe there are complications associated with it- I was under the impression the docs do not routinely perform surgeries like that just to correct length-

I saw a tv story on this a longtime ago... yikes!!! they showed this boy's leg in this halo type brace - they drill it into his bone and then separate it more and more as the bone heals....ohmygosh - it must be SO painful! I think your child needs to be older and really has to see the whole concept, understand the pain involved and know all the facts up front so that THEY can make this decision for themselves... seems very extreme to me - I may be wrong - things might be very streamlined now...

-francine

Hello,

It depends on what is causing the arm to be shorter. If it is a result of an elbow contracture, then there is a surgery for that where they lengthen the bicept tendon. This is done after therapy and extension splints do not help release the contracture. My son just had this done. He could not fully extend his arm so it appeared smaller. Now, he can extend his arm and I do not notice a difference, his arm actually looks much longer. This is not a bone surgery, rather a tendon surgery. Generally, this is done when the child is older, Mine was done at three and half to avoid bone deformaity as therapy was not helping the contracture to release. Hope this helps... Best of luck.