United Brachial Plexus Network

My name is ken, my first post was on Feb 17 02.I am going to see DR. Kimble on april 8.I would like to know how many of you were paralyzed immediately? It is important to me becuase my arm was not flail after the injury. I will show him the post that i receive. Thanks Ken.

Hi Ken
I was under the impresion that all tbpi's were paralyzed steight after the trauma,but i could be wrong

karl

Thats the point i want to make to DR Kimble. my hand was numb but i could move my arm and fingers after the accident. ken

Karl, this is my point!my hand was numb, but i could move my arm and fingers in the ER. Ken

Hello Ken,

I think it depends on the severity of the injury. My nerves were not torn from the spinal cord...just stretched. So the problems with my neck, shoulder and arm did not show up for several weeks. As everything else healed those areas got worse. I was not diagnosed with a BPI until almost two years after the accident. By that point I had no control over my hand, no feeling in the arm or hand and lets not forget the incredible pain.

I am not sure if this is what you wanted. Hope it helps.

Joy

Hi Ken, i did some research but not much help with your specific question, i thought the same as karl, ie that even in mild injuries the initial presentation was a flaccid arm, but all these injuries are different! I found some info re bpi caused after dislocated shoulder and i'll write it here direct from the book:
'The ealiest description of traction lesion is that by Flaubert (1827) who described the late reduction of dislocation of shoulder by manual traction. Six students pulled upon the limb, the result was catastophic and the patient later died. (!!! You were lucky!) Flaubert noted a Bernard-Horner sign long before this was formally described, and also described an affection of the cord. At necropsy a rupture of C5 was found, with avulsion of C6,C7,C8 and D1, and rupture of the subclavian artery. The radicular vessels had also been ruptured, leading to a haemotoma within the spinal canal.'
This has been taken from a paper by AC Flaubert published in 1827, if you want to know its title i'll post it but it's in French! So it looks like the earliest ever description of a traction bpi was related to a botched attempt to resolve a shoulder dislocation. The part i have quoted is from the book 'Surgical disorders of the peripheral nerves' by R Birch et al. Hope this helps, let us know what the Dr says.

Hello Ken
I have been told that my arm was paralysed immediately, as it was suspected that I had all 5 major nerves avulsed. When the injury was further investigated, this turned out to be right, and I believe that with nerve avulsions the paralysis is immediate. Hope that helps a bit..good luck with the doctor.

Hi Ken.....the only part of my arm and hand that wasn't immediately paralised was the very tips of my fingers. I could only bend them inward....not out. I suspect that this was a pretty good clue as to why the docs wanted to wait, why they believed mine was only a severe stretch. As far as shoulder dislocation goes......mine was out of socket near eight months before I was able to hold it back in on my own. Good luck with your doc visit tomorrow !!

George

Hi George,

Hope you dont mind me asking but did you ever have any surgery or did you decide to wait,And have you had any improvement.
The symptoms you desribed were the same as me (only slight finger movement)
It must be a terrable decision to make.

karl

Howdy Karl,

I see from the other post that you're getting on good after your transfers.....good go mate !! No surgeries yet. It seems that through this whole ordeal everytime I would mentally prepare for a surgery, another part of my arm would wake up and decide to work. But I think that I have gained about all I'll get. Saw the specialist last month, and he thinks the only transfer I would need would be to the thumb. Said it would be outpatient and that I'd be home that night. So thats where I am. Believe it or not, the extension on my three outside fingers is definately improving and getting stronger (it's all relative of course-not a whole lot of strength). I would have swore eight months ago that they were toasted.

I put a lot of faith in my docs, Karl. I know I am fortunate that they were right in their diagnosis. It was a crap shoot. So.......I may give it a little longer. Not being able to manipulate my thumb and forefinger gets frustrating.........but then again.....what else about this injury isn't ??? )

George