United Brachial Plexus Network

Hi!

My daughter has an OBPI with 4 nerves avulsed. Had nerver grafts at 4m, botox at 2, and at 5 had the tendon transfer/shoulder release. She can mover her arm up a lot more, but her internal rotation is terrible now. She can't even get to the zipper on a jacket. Her arm hangs out to the side quite a bit. I'm worried about her getting in all these awkward positions to do things like write. Anyone have any experience with this? Tips?

Thanks!

Jessica

How old is your daughter? My eight year old had pretty limited internal rotation after his shoulder release at 1 year of age and I worried if he'd ever be able to button or zipper clothes. He's 8 now and he's really improved tremendously in the last three or so years with this. I think it was largely a function of increased body awareness and better muscle coordination. We didn't do anything specific and he hasn't lost any other function (so no reason to believe subluxation is the cause although sometimes it is).

Kate

My daughter is 6. I think it's the tendon transfer more than the shoulder release that puts her arm at the strange angle. Did your son do PT or OT?

Thanks!

Jessica

red8ii8 wrote:My daughter is 6. I think it's the tendon transfer more than the shoulder release that puts her arm at the strange angle. Did your son do PT or OT?

Thanks!

Jessica

Hi Jessica,

My son did tons of PT but now only does karate and swimming. I've heard some kids who had excessive external rotation after tendon transfer sometimes get a reverse shoulder osteotomy to bring the arm in better. Maybe you can talk to your BPI specialist about that? But it hasn't been that long after the tendon transfer, so I think you still have some time. It sounds like maybe she's developed an abduction contracture? (arm doesn't hang down to the side but is always "lifted" up a little). We had something like that start up with my son right after his shoulder surgery, but we did tons of stretching of his deltoids/supraspinatus and his arm came back down.

Kate

Kate