United Brachial Plexus Network, Inc.

My daughter has about a 15 degree contracture at her right elbow. Are there any EFFECTIVE alternatives to surgery?

Thanks,

Cheryl

We've had our daughter wear a plastic molded brace at night to go from a 30 degree to 10 degrees and prevent the contracture from getting worse during growth spurts. There's no special name for it. It was made at Shriner's but it is just a moldable plastic with 3 pieces of velcro that they placed on it to hold it in place at night only.

I've heard other parents speak of botox with serial casting as well, but for a 15 degree contracture it seems like that would be a bit much. Is it bothersome to your child for function or is it more a cosmetic issue?

It's my understanding that if you are considering the bicep lengthening for an elbow contracture, then as a child goes through growth spurts, then there is the risk of the contracture returning at that time. This is why our daughter wears the splint at night to prevent a return of contracture, even though hers has gotten down to 10 degrees which in our mind is pretty good compared to the 30 degrees it used to be at.

Tanya in NY
Amber's Mom, ROBPI, 4 years old

She is completely functional. Out therapist is using theratogs on her now for strength but she does not think there is a lot she can do outside of recommending surgery for the contracture.

We did modified/light serial casting. There was no botox involved. Every 2 weeks we had a new cast made which was removable. My son wore it only at night and a little into the morning. It worked very well for us, taking him from 35 degrees to near zero. We had also tried a static splint (which Tanya talked about) and a Dynasplint, but neither worked as well and was as comfortable for him to wear as the removable cast.

Good luck to you...

Hi Cheryl - there's a discussion about fibrotic muscle on this post. Ihis may be helpful for you to read.

http://ubpn.org/messageboard/thread ... 601#129601

What has worked really well for me is a static splint with a neoprene sheet strap instead of velcro straps. I cant have any direct puessure on my elbow or I develop pressure sores so the neoprene sheet strap was suggested and I love it! I think my contracture was near 30 degrees when I started and now I am passively at 6 degrees. Now I just need to work on active range.

Good luck!
Hugs,
Amy 19 years old ROBPI from MN