Cincinnati 3 months later
Posted: Sat Aug 30, 2014 12:15 am
Finnley has come a long way and is actually crawling despite her LOBPI. However, she is still limited in ROM and holds her elbow bent with her arm in toward her chest alot. Because of this she is still very tight. The doctors did decide to do botox in three muscles and put her in a night cast to stretch her muscles.
Here is the explanation of why we did what we did and what we are trying to avoid: we injected the 3 muscles to weaken them to allow for better range of motion and for therapy to work the back muscle (the infraspinatos) better. Also by keeping the dominant muscles loose this allows the shoulder to develop in the right location due to all the muscles exerting the same balance of power, so to speak. We are trying to avoid surgery because if the infraspinatus (active external rotation) does not strengthen to a point of balance with internal rotators, the bone will grow incorrectly and potentially dislocate (worst case scenario). If the infraspinatus does not work well, tendon transfers of the Latissimus and Teres Major are need to become the active motors for external rotation instead (moved from being an internal rotator to external rotator).
We go back in six weeks for a new cast and then 6 weeks for another indepth eval to see if the botox helped.
I guess I'll be updating again in 6-12 weeks.
Here is the explanation of why we did what we did and what we are trying to avoid: we injected the 3 muscles to weaken them to allow for better range of motion and for therapy to work the back muscle (the infraspinatos) better. Also by keeping the dominant muscles loose this allows the shoulder to develop in the right location due to all the muscles exerting the same balance of power, so to speak. We are trying to avoid surgery because if the infraspinatus (active external rotation) does not strengthen to a point of balance with internal rotators, the bone will grow incorrectly and potentially dislocate (worst case scenario). If the infraspinatus does not work well, tendon transfers of the Latissimus and Teres Major are need to become the active motors for external rotation instead (moved from being an internal rotator to external rotator).
We go back in six weeks for a new cast and then 6 weeks for another indepth eval to see if the botox helped.
I guess I'll be updating again in 6-12 weeks.