United Brachial Plexus Network, Inc.

Hello.
My daughter has been referred to have a humeral osteotomy and I am concerned that she may lose the strength we have worked so hard for in her arm. She was born without any movement in her left arm, she has had 2 surgeries (mod quad at 6 mo. & triangle tilt at 9mo.) and now she is about to turn 3. She has much more movement in her arm, the scans show that she has good alignment in her shoulders, the only thing is that she is externally rotated. We have tried a brace to correct this and it didn't work. Anyhow, long story short, a humeral osteotomy is recommended and I am not sure how to get the information to 1. make the decision and 2. decide between 2 surgeons....Dr.Davillo in Houston and Dr. Kozin in Philadelphia. I would appreciate any and all feed back either with prior experiences, shared information, etc. Thank you in advance for your input.
Thanks!
Kerri

At one point many years ago, Maia was going to have a humeral osteotomy. I spent a lot of time researching. There are big differences between how all the doctors do their osteotomies - I think the most important part is where they actually make the fracture - because where they make the fracture decides what muscles go along for the ride -- and that defines increase or decrease in function. If I were you, I'd meet each doctor and ask important questions: (here are some that I asked)

(1) for my child's issues, where would you fracture and why
(2) where do you make the incisions? and why
(3) does the hardware stay in or does it get removed and if so, when
(4) what happens when a child falls and the hardware breaks?
(5) how will you determine how much to turn the arm?
(6) my child plays (instruments) (sports) or loves to (knit) (or whatever) - will she be able to do this after the surgery
(7) with every surgery there is a gain and a loss -- what will her loss be?

There is also Dr. Paley in West Palm Beach (and another doctor in Arizona - don't remember the name but can find out for you) who does the osteotomies but uses a brace called the Ilizarov which allows the patient to determine how far the arm should be turned (and the arm can be lengthened at the same time). That could be something else you might want to consider looking into. However, follow-up is also a consideration. There is a LOT of followup (I believe it is every two weeks for quite a while) for the Ilizarov - so you need to ask about that.

And finally -- is the arm casted? braced? and if so for how long? what will the child be able to do or not do during the healing time.

That's all I can think of for now.... best of luck,
francine

My daughter is 9 - this surgery was recommended for her as well. I have had a hard time finding information about it. I would be interested in hearing someone's experience. What was gained and what was lost with the surgery. I have asked a lot of questions but still want more answers. Who is the doctor in Arizona who does this surgery?

My son had the Osteotomy with Dr. Kent VIncent here in Tucson, AZ and he did a great job. Feel free to email me and I could give you more info. o l a f f e r t y (at) c o m c a s t . n e t (I typed my email like this to cut down on spam.)

http://orthoforkids.com/

It's been so long since I've been on the boards here that I'm not sure how to use it yet but I could post a picture if I could figure it out!