United Brachial Plexus Network, Inc.

Hi
Our 10 year old daughter had the mod-quad surgery with Dr. Nath when she was 2. We just met with Dr. Nath today. He suggested the Forearm Osteotomy because she is unable to place her palm flat down.
Has anyone had this surgery? Can you tell me more about it?
Also wondering if OBPI patients have pain later in life. My child has no pain--but I worry about pain in the future. Is the pain in the injured arm or other arm?
Thanks!
ksass@cedargrovebelgium.k12.wi.us

With that surgery, I could suggest waiting and doing ROM and strengthening exercises. I would love to share results on my procedure that I will be having in a month. I have been offered a forearm osteotomy and a biceps rerouting but with both of those you lose the abilityto supinate. Then it becomes a matter of which is more important personally, I cant pick because I havent had the option of pronation as I am supinated.

The procedure I will be having will take a tendon from my ring finger and reroute that into the pronator teres to give me something extra to work with. Seems like a good option right now and the best part is I wont lose my supination.

This is a surgery that can be done at any time so I really would suggest waiting! And I would love to share if I get results from this procedure as it seems more like a win/win situation instead of a win/lose.

Hope that helps!
Good luck with your decision! Or rather your daughters decision since she is 10 years old, its her life.
Amy 20 years old ROBPI from MN

Thanks for your reply.
May I ask who is your doctor? Did you ever see Dr. Nath?
Was your injury a birth injury?
What other surgeries have you had?
Thanks for your info...
you can email me directly at ksass@cedargrovebelgium.k12.wi.us

you have email
Amy

Hi, I am Angela, Mom to Jill, now age 23, severe Left OBPI. I agree with Amy about waiting.
My Jill was Palm Up (supinated) and then eventually froze with her forearm/hand neutral......ie mid way between palm up and palm down. As if to reach out to shake someone's hand.

This surgery had been considered for Jill when she was about 7 or 8. The O.T. did not like the idea. She said NEUTRAL was much better functionally than palm down (pronated). Jill and I did do a lot of therapy to get her from PALM UP, to Palm Neutral.

The O.T. said you need to be palm neutral to dress yourself......ie try to button the front of your shirt, if you are palm down.....now try neutral. Reach your hand up to touch, comb your hair...put in a pony tail.

I forgot to mention one thing tho.....Typing.
Jill types with ONE hand. She seems to do O.K.
She had a lot of reports, Papers, etc to type for College. In that respect, the fingers of Jill's hand never worked all that well to type with her left anyway.

If typing is your main concern. You could pose that question to others at this site.

I also type one handed. With some practice and now two years of college papers I have gotten very good at typeing one handed.
Amy 20 ROBPI from MN

My son is 3 1/2 years old and Dr. Nath also recommended him to get the forearm osteotomy last year. Did he refer you to Dr. Nelson Davino? We still haven't been able to make a decision on if we should do it or not. I have talked to Dr. Davino's staff and asked them to please give me names of people who have had this done, and still haven't gotten any response. We just want to know if this will help a little or a lot. It's really frustrating for me I don't want to mess his hand up anymore then it already is.

Is your daughter's injury affecting the upper or lower arm? My son's injury is rare it affects his lower arm and mostly his left hand. He has great upper motion but can't fully open his had all the way. Plus his arm is shorter and smaller then his right.

Hope to hear back from you...
Andrea

Andrea,
my personal opinion is that these elective surgeries should be the childs choice. There is no time line at all on this surgery, I am 20 and it was offered to me. This is a surgery that you give up one entire function to gain another and how do we know if the other is what we want for the rest of our lives. I would not rush into this surgery at all! Wait 5, 10 years and see what your child wants. I personally can not go forward withthe osteotomy at this point in my life, I have supination now but if I give that up for pronation will I still be able to do all the things that I do now? Thats a question I can not answer so I cant go forward with that surgery. Instead I am trying a tendon tranfer into the pronator teres to see if I can get some pronation that way and I wont have to lose supination!

Surgeries choices with out timelines should be left up to the person affected. Thats just my thoughts.

Amy 20 years old ROBPI from MN
hope16_05@hotmail.com

my son had forearm osteotomy done 1 year ago without any success. He was pronated trying to gain some supination or at least neutral. He was 8 yrs old at the time. Very easy surgery, but perhaps one that you could wait for. He has had humeral osteotomy done too and didn't gain much then either. We need to address his shoulder issues, then maybe he will get some supination. feel free to email me if you have any questions.