United Brachial Plexus Network, Inc.

I just went to the Chicago picnic, and had an evaluation from Dr. Nath. My shoulder is a little tight and Dr. Nath recommended the Mod Quad. My main concern is my elbow contracture, as my shoulder seems to move much better than some of the injuries I had seen, and I don't want to do the surgery if it will make it worse or weaken my muscles as my main concern is more of the elbow contracture, and not my shoulder movement. I can touch the back of my head, and raise it up even to my shoulders,and I do not want to make this worse.
I would like to know if any of you after having your Mod Quad have noticed any weakness in your shoulder muscles, chest muscles, or any other muscles from the surgery.
Also did you develop any pain.
Most of you have written that it has improved your ROM-however is there anything from the surgery that you have seen or felt that you are either disappointed with, or wish the surgery would have helped?
Also my elbow contracture is at 90 degrees which is tight, and would require multiple surgeries. Dr. Nath recommended the DynaSplint to see if it would help stretch out my arm and gain length to minimize multiple surgeries. Did any of you have an elbow contracture, and if you did-did you use a Dyna Splint or have multiple surgeries?
From reading the message boards I realized you are the adults that have gone through this, and I would appreciate any insight you may have for me to make the right decision on these surgeries.
Nancy-how long has it been since your Mod Quad surgery? Since this is a fairly new procedure have you noticed any set backs or parts of the surgery that has not worked for you? I'm wondering what the future holds for this surgery in adults, and since it has been some time for you just coureous to see if anything has regressed or come back.
Sorry for so many questions, but trying to decide what the right step for me as far as pursuing surgery or not. Thanks for your time, and if anyother adults have gone through these surgeries your insight would be of value too...

I have to preface my remarks by reminding us all once again that the mod quad will differ depending upon the extent of injury and the ensuing contractures. So our results will differ and so much depends on how we are injured.

So having said that, no, I had no weakness in my shoulder muscles, because, for me, those were the ones that were the weakest to begin with. I could only raise my arm 45 degrees pre surgery and am now at 110. My biceps were strong creating the internal rotation and I had little external rotation. Now I have less internal and I can rotate some externally.

What I lost, I eventually gained back, but it took several years. The only deficit still remaining is that my biceps are weaker and so I have lost strength. But that tradeoff I would give anyday for all the other things that resulted -- increased pronation and supination, finger movement that I never had before, stabbing pain that disappeared in my shoulder, and raising my arm to 110.

I did develop some pain in my wrist and had to have some decompressions done a year and a half later, but that is most likely due to the fact that I had increased movement in my hand for the first time and my wrist is very very small and the resulting carpal tunnel is very small. The decompressions worked so well that they gave me even more flexibility in my hand.

So ... now I am almost 4 years later. No regressions, no recurrence of pain. I only wish I had done this earlier in my life.

Nancy

I just had mine done in April. Right after the splint came off I did have weakness....just cause my arm hadn't moved in a month. Once in PT, though that cleared up in about a week or two.

Before surgery, I couldn't supinate at all, now I can almost get my hand over, just enough to be able to use it to put shampoo in and not have it drip off my hand:)

Before surgery, I couldn't lift my arm.....maybe 20 degrees (if that). Now I can lift to about 90 degrees, but I still have a bone spur and I think that is impairing some of my movement. I see Dr Shenaq this Friday to plan the surgery for that.

My arm was only slightly bent, but now I can completely straighten it.

My hand use was very good before surgery, and still is.

The only problem with pain I am having is during ROM exercises. When my arm is lifted the impingment hurts and will put my arm to sleep quicker than a wink. So I must be very careful. Once Dr Shenaq takes that spur off though, I don't expect any problems.

I will say I found the splint EXTREMELY uncomfortable. I was pretty miserable that 4 weeks with it on. Sometimes when I would go out for very long I would be in enormous pain afterwards. But even still I would do it again....those 4 weeks are nothing compared to standing in front of the mirror yesterday and putting a ponytail in my hair without help.

Nancy is correct in stating that every situation is different. I am almost a year post op. I can tell a great difference in my arm. I even gained 2 inches in length from having the mod quad done. My biceps were weak to begin with as well. I am still having some weakness in the bicep area, however, more physical therapy and strengthening can increase it. It truly depends on how hard you are willing to work after the surgery. Dr. Nath is a tremendous surgeon and person in general and he would not steer you in the wrong path. Good Luck on making your decision.

Thank you for all your valuable information. I think I may just concentrate on getting the elbow contracture done as I have been blessed to not have had any pain, and I have never needed help in getting things accomplished such as hair washing, ponytails, etc. I think I will see what my arm does after fixing the contracture. I've waited 31 years, what is another 1-2 years for the Mod Quad if I decide to go that route. Thanks you all again