United Brachial Plexus Network, Inc.

I know tthat a humeral osteotomy straighens the elbow. Does it also help with pain on the inside of the elbow? My 14 year old daughter is considering having surgery this summer. Thanks.

Can anyone help?

Hi Corrine:
I don't know which doctor you are planning to use for the osteotomy, but you should get at least 3 opinions.

The osteotomy is a surgery designed to reposition the hand. It does not straighten the elbow. The bent elbow is due to two things: 1. position of the humeral head in the shoulder socket and 2. contracture of the biceps. So, if while you reading this you internally rotate your upper arm, you will see that your elbow naturally bends. This is what happens when there is internal rotation of the shoulder--a common effect of the injury (the pecs are not effected by bpi). And, when you add to that contracture of the biceps, also common, you get the standard bpi posturing.

So, why do an osteotomy? Well, if all efforts to put the shoulder together straighter (mod quad, tendon releases, botox, etc) fail and the arm is still very internally rotated, the osteotomy will turn the lower part of the arm into a more useful position. With the use of the osteotomy, you are "giving up" on the shoulder correction and turning to a bone correction of the lower extremity. If there is a contracture in the biceps, that can only be corrected by strengthening the triceps--not by using the osteotomy.

I know of a number of children (most are high school and college aged now!) who had the osteotomy and were thrilled with the results. The plate can be left in or removed, depending on the surgeon and the child.

Remember that you don't want go into this surgery quickly. It is permanent. If your daughter has pain inside the elbow, you might want to consider other reasons why it hurts. You might want to try massage therapy or some other modality before you go to a surgery that was designed to give better function. You don't say if your daughter has good function, only that she has pain.

And, I can not stress this enough... YOU MUST GET MULTIPLE OPINIONS. you might be pleasantly surprised that a doc notices something that can be dealt with WITHOUT surgery.

BPI is life changing.. not life threatening. So know that you have time to make this decision.

Does that help?

claudia

ps. not sure where you live, but we use Dr. Kozin at Shriners in Philly, Dr. Price in NYC and Dr. Waters at Children's Hospital Boston. Plus, we have taken her to California, she has seen Gilbert while he was here in the states... We also use Dr. Armenta in Houston.

YOU MUST GET MULTIPLE OPINIONS. you might be pleasantly surprised that a doc notices something that can be dealt with WITHOUT surgery.

Best advice ever for any surgery.

Carolyn J
LOBPI/74++++ sometimes "bossy gramma"

Thank you!