United Brachial Plexus Network, Inc.

I found this article during one of my endless info trawling sessions, it's very interesting. I was especially interested to read the very last paragraph, where it says 'most patients with flail arms recover elbow flexion with thelower arm grazing along the chest'....this exactly describes the recovery I have had, but I always thought i was very lucky to get this....did those of you who had no surgery get this too? Mine didn't come in for at least 2 years.... just wondering if this is as common as this surgeon says, or not. Here's the article http://www.goa.org.in/aos/anil_lec.htm

Thats a good article Jenny. The doc is pretty straightforward with his methods. I guess all of my recovery was spontaneous. But my deltoid kicked in first at 3 months. Bicep started to breathe again at about 9 or 10 months, with good strength recovery soon after. Lots of work though. External rotation came back too, but it is still not real strong, and hurts the most of all my home exercises. Still a lot of pulling and popping in there. My arm grazed the chest at first, but since has gotten better.

The article mentioned Horner's, and a lack of facial sweating. I don't think I was affected, but I've never really paid any attention. I don't sweat on top of my forearm at all....skin gets dry but doesn't peel. Anyway, what part of the affected facial side doesn't sweat?? Is it the complete side of the face, just around the eye, where exactly ??? Guess I need to check this out. My eye on the affected side is a slight bit lazy....not really noticeable until you look close. I don't remember seeing this pre-accident. It itches a bit more too, and seems to be more sensitive to light now. It dilates normally........I think )

George

Hi Jenny,

Great article. Another good handout. I wish this doctor was practicing in the U.S.

I reread the statement about "most patients ususally recover some elbow flexion", but I think it's an outcome prior to the secondary surgery he outlined.

Then again, it's late and I'll reread it with fresh eyes in the morning. Thank's so much for passing it on.

Mary

Yes Marylu, it's a bit ambiguously written, i thought that but then the next sentence goes on to say 'Hence i recommend bla bla bla '(secondary surgery to optimise the elbow function)-it seems to indicate the secondary surgery is to enhance the natural recovery. Over the years i've been 'talking' to others who haven't had surgery, quite a lot of us do seem to get some biceps back....i certainly wasn't expecting mine to recover but it did.
It is a really clear article tho, tbpi's are VERY common in Asia so i guess they have quite a lot of expertise there.

Yes...it would be interesting to find out just how many people actually do regain a certain amount of function in the biceps in particular, without surgery, and why.

Any other long termers (blimey, sounds like a prison sentence...)had this apparent re-generation?

It seems that most reconstructive surgery includes reinnervation of the biceps as a priority, even if nothing else can be done. This is maybe because it is the easiest one to do because of its proximity to the brachial plexus itself, and any regain is better than nothing.

Unfortunately, in the U.K. anyway, most people with a really long term BPI have long since had the arm amputated, so it will be difficult to research this one question; would biceps function return anyway eventually without surgical intervention after a certain amount of time? Is the bicep function return actually the bicep itself working, or chest muscles working together to produce the same action?

Liz B

I did have surgery, but supposedly, the surgeon didn't mess with the nerves controlling my biceps. I have regained quite a bit of strenghth in my biceps in the last 6 months. I'm just starting to be able to actively use the curl machine at the gym without any added weight. However, if I let it go too far down, I can't bring it back up. I have a lot more strenght if my elbow is slightly bent.

i am now 3 years since ltbpi and have, without surgery, regained enough strength to pull my lower arm to 90 degrees against gravity. also just recently i noticed i am able to start moving my arm back and forth using my delts. don't know how much more i'll get with total avulsion on c8, t1 and partial avulsion of c5, c6. but there's always the hope of being able to control a prostethesis. hope this helps.

GOOD POINT LIZZ. i THINK MY CHEST ARE PULLING MY ELBO FLEXTION ON A TABLE. I PLANE TO HAVE EMG SOON TO SEE WHATS DOING IT. PAUL

Just found this post on the gen board....my biceps recovery happened outside the 'normal' timeframe, but nothing like this....wow!

Re: Avulsions Bill Posted: Jun 15, 2002 12:32 PM Reply

> In reading your response in relation to avulsions I would tend to agree that what you had stated was the "normal" medical advice in terms or nerve-muscle reinnervation. EXCEPT... there are instances that the "window of regeneration stays open."

I am right tbpi. C8 pulled from the cord C5, 6, & 7 extensively damaged from a motorcycle accident in 1985. In the winter of 2001- 2002 my pectoral muscles (wiped out in the accident) reinnervated and I now have limited use of themn - not enough to move the arm, but... Also my wrist and fingers now have limited motion in them as well - regeneration within the last two years - and I am post injury almost 17 years. I am certainly not very functional with the fingers and wrist, but it is still pretty cool that the Drs. don't know everything...I excercise them when I think about it and they definitely are getting stronger.

So there is always hope beyond the usual medical definitions...

respectfully,
Bill

I can now lift my index finger almost a 1/4 of an inch. My thumb now can lift itself just barely enough to slip a piece of paper under it. No feeling but its movement. Its been almost two and a half years since the accident. Doctors gave up all hope at six months. So I agree with Bill, doctors do not know everything.
Mindy