United Brachial Plexus Network, Inc.

Any one who has has this procedure what kind of results did you see and if you don't mind at what age did you have this surgery?
Thanks,
Amy 18 ROBPI from MN

I had this a little over a year ago, when I was 36. Dr Shenaq did the surgery.

I had hoped for more than I have ended up with, BUT I do know I was wanting the moon, and I knew that most likely wouldn't happen. Before surgery, I couldn't touch my face with my BPI hand...I could almost get it to nuetral (I couldn't supinate at all)

Now I can put a ponytail in my hair, it is difficult, but do-able. I can supinate just past nuetral with no help, and with help I can turn my hand completely up.

I do still have a bone spur in my shoulder though, and that is most likely hampering some movement. We must finish paying for the Mod/Quad before I want to get that spur taken off.

Kimberly
Age 37
LOBPI

I had the mod quad surgery two years ago with Dr. Nath. I am age 33 LOBPI. I regained two inches in length with my surgery and have way better hand movement then I had before. I could not cross my fingers before and now I am able to on my affected side. I also gained a bit more rotation in the affected side as well. It was a great surgery to have but remember everyone is different too.

Exactly what Rachel said......everyone is different. I think it just depends on how damaged your nerves are. I had the surgery in March and really haven't seen much difference. I was hoping to be able to lift my arm above my head, hasn't happened. Passively, I'm loose but really haven't gained any active motions. I also know there others adults who have gained as much as I have or lack there of. It really depends on your injury and how extensive the damage is. My opinion, anyone who has all the nerves damaged and is an adult, get more than one opinion before spending the time, energy and money.

My problem is that I do not know what nerves are injured, I have never been told to what extent my injury is. I have had 2 EMG's but those were from when I was 6 and 7 maybe. Now no body knows how to read them, so they are worthless to me. What test will tell me to what extent is my injury?

Amy

I had surgery at age 35, just over a year ago in Australia. Similar procedure to mod quad (transfer lat & teres, release pec & subscapularis and some removal of bone). My injury is global with all nerves affected to some degree. In the main however, I think my movement limitations were reasonably "common" to this group, including no external rotation, inability to lift arm above head, to face, etc.

Although my internal rotation muscles including pec, lat, etc had mild deficiency, they were still reasonably strong and I think this is one factor you would need to consider closely when aiming for "active" improvement. Ie, if your lat/teres is reasonably weak, transferring for external rotation may still not overcome remaining internal forces.

In my case, I consider myself fortunate, I can now lift my arm above my head (approx 160 degrees active), I can externally rotate (just past neutral active which is enough and certainly an improvement on nothing) and can now touch head, face, etc. I am certainly not strong in these ranges and trying to wash hair, etc with this arm is quite awkward, however should something happen to the uninjured side, I am certain I would now cope better.

Main downside for me was/is loss of internal strength and active movement. I still have reasonably good passive range, however when concentrating on bringing arms together at front, I get to a point where (I assume) the lat in its new position and the pec (in lengthened/released position) tend to balance each other out and I cannot actively move my arm across the front (if that makes sense?).

I would certainly follow others advise and speak to other Drs, get nerve tests, MRI, etc and try to fully understand your injury/limitations and "potential" benefits (or losses) before you proceed (or not).

FYI, I discovered this site at beginning of 2004 and at that stage new absolutely NOTHING about my injury, what it was called, what was effected, etc, etc. Before that time I did not have any idea that anything could be done.

Good Luck

Glen

Amy, James had MRI's after his accident and they could almost tell positively which nerves he had avulsed. As a mater of fact, the ER neuro diagnosed the exact nerve avulsions that the Dr. did who did his surgery. The biggest problem with the MRI at the time of his accident though, was the amount of swelling he had. It was kind hard to tell. But the only sure way they told us was by exploratory surgery, and they repaired them then.

Kamren, If you dont mind me asking, do you still see Dr. Shenaq for follow ups or anything? My son had his first surgery with him. We first met him in NC, thats where we live.

I haven't seen Dr Shenaq in almost a year. I saw him for my last follow up right after our insurance wouldn't let me go to PT anymore. He wanted to schedule the surgery to get the bone spur out then, but I told him I wished to wait til we finshed paying for the Mod/Quad. Once we finish that I will go back in and see him about the spur.

I am 38 and had Mod Quad In January 2005. I have gone from 45* to 112* straight out in front and from 25* to 90* to the side. There is still some tightness to the back of the arm although passivly I am opened to 180* and continue to work through that. The physiatrist who did my MRI could tell exactly which nerves were affected because she tested each one separetely. I am only injured at the C5 so my deltoid is affected but my arm is straight. Even though it is my deltoid that was afected, I have learned that some other muscles are also weak just due to non use due to the deltoid problem. So have been learning to use my rotary cuff muscles and a few little ones that act to raise the arm that simple have never been used before. My therapist is working with me to learn "muscle patterns" so the arm moves correctly. For instance, above 90* my shoulder doesn't want to stay in the socket correctly because these little muscles don't know their job and others, used to taking over, are still trying to help out. So I do lots of repetitive motions to get the correct neural patterns established.
My sister was injured at the C7 so her arm is bent but she can lift it overhead. She is 44, did not have any surgery and just last Thursday had to have surgery in her elbow because of pinched nerves that were trapped. She was quickly losing function and had a lot of numbness. Her good arm has the same problem due to overuse and she will have the other arm operated on in a few months.
The range I have gained so far made it well worth the surgery even if I get no higher. Just to close my car door, put up my hair, wash my hair, reach the butter in the fridge, etc is such a blessing. My arm is also a few inches longer too now since my shoulder has moved out and isn't so bound up now.
You have to be very dedicated to physical therapy though. I still stretch 4 times a day and exercise the arm 3 times a day. Many movements above the 90* level started with absolutely no response or control and then slowly I started getting a response from my arm and control followed so it is a slow process for me above that 90* mark. But my arm has never seen that range so it was expected. My therapist says my upper range is like that of a 2 month old baby - they don't have a signal or control yet either and it takes months and a strong will to build the new neural connections so they can reach that rattle and then shake it with conviction. And they can be built - I just discovered I can reach the very top shelf of my closet yesterday. I am not very functional at that height but that will come just like it did at my lower shelves. Recovery is mostly pure will and determination and a few tears of frustration. Suzy