United Brachial Plexus Network, Inc.

I am so glad I had a derotational osteotomy done on my son. He now has much more functional use of his right arm than he has ever had before.

I wanted to post this note on the web site to tell everyone about my son’s results after having a derotational osteotomy and why I am glad we did it. Robby is 4 years old. Robby has a severe right brachial plexus injury due to the fact that he was a 12lb. 8oz baby delivered vaginally, my physician had no idea he was that big, he suffered from shoulder dystotia (spelling?) at birth. He has had nerve graphs, nerve decompression, the mod quad surgery, and a capseodisis (spelling?). Even after all this he still had extreme limitation as to what he was able to do with his right arm and it was always up in front of him and very pronated. Dr. Nath said that he thought an osteotomy would be the next thing to try with Rob. I was very unsure when we made the decision to have this done. All of my son’s surgeries had been done at TCH, and we always saw some improvement after each surgery. Since this was going to be an orthopedic procedure my insurance company would not let me go outside the network if I could find someone in Omaha, Nebraska that could do the procedure. I found Dr. John Sheehan. He was willing to call and talk to Dr. Nath and discuss Robby with him. I wrote Dr. Nath and asked his opinion of Dr. Sheehan and he said he felt very comfortable with him doing the procedure. Dr. Sheehan said that although this would probably help Rob he might have to have another surgery of the same type down the road because some times these surgeries won’t stay. I still was unsure but we decided to go ahead and have the surgery done.

This surgery was done in September. Before the surgery my son had never been able to bring his right hand to his mouth or put it down at his side. Now his arm is at his side, no longer up in front of him, and he can bring his hand up to his mouth. He is able to clap. His right arm is in a much more functional position. He still gets frustrated at times, his arm will never be normal, but he is so excited when he finds new things he can now do with his right arm. Every day he is able to do a little more. He is discovering he has so much more independence.

I am sorry this is so long but I wanted to share our story and tell everyone how much this surgery benefited us.

Ruth,

Our son had this same surgery done in November and the difference is almost miraculous. We are glad we did it too.

Good luck with his continued recovery.

Missy

I was reading your posts about shriners. I am sorry to hear that hospital is closing. It is miraculous the change in my son. So I know what you are seeing.

Ruth - do you have before and after pictures? And also could you write down what he could not do before and what he can do now? I'm trying to write up pages about the surgeries and this would be so helpful...that is of course if you want your son on a page on injurednewborn.com... let me know ok?
-francine

Silly me.... forgot to say...CONGRATULATIONS TO SUCH A SUCCESSFUL SURGERY !!!! Dr. Nath had said that osteotomy is in her future and I get so stuck on 'how' they do it that I can't even see the benefit....for now at least.

Thanks so much for posting because it's going to help me get over my queasiness about it.

-francine

I am at work right now but I will look for some before pictures.

One of the more noticeable differences is the arm is finally down by his side. Before the surgery it was up all the time and out in front of him with the hand turned very pronated. When people saw him they new he had a problem with that arm but didn’t quite understand his injury. Now when people see him they cannot tell unless they watch him for a while. I sent his therapist a picture of him in his Halloween costume and she showed it to other therapist in the office and they couldn’t believe it was Robby, they had never seen him with his arm down in a normal position. This makes me feel better because you know how people will judge someone just by looking at them, now at least they will talk with him before making judgements.

We did have a few problems after the surgery. First was he broke his cast 3 days after surgery at night. We called the hospital and asked what to do? Whether we should take him to emergency or what? They said to just make him comfortable and bring him into the doctor in the morning. I told them that was easier said than done. The Dr. had made Rob’s cast before surgery and then just cut it and taped it on Robby after surgery. I told the nurse that there was a support hanging down and that there was no way to make him comfortable until morning. I asked her if I could remove the cast and use the splint we had from the capseodisis surgery in Texas and she said what ever I had to do to make him comfortable. The doctor had put a plate in Rob’s arm to hold it so I wasn’t to worried about it coming out of place. When I saw the doctor the next day he said if he new I had the splint he would have used it instead of making the cast. Lesson if you don’t go to Texas at least have them make you a new airplane splint before they do the surgery and use it on your child. They took him out of the cast 3 weeks after the surgery. At this time the doctor left me alone with Rob and told me to see if I could get him to bring his arm down. I just sat with him and massaged his shoulder while holding his arm and slowly brought it down to his side. When the doctor came in he was very pleased and put a type of immobilize on Rob to just keep the arm down at his side. This was a big concern of the doctor after surgery because he said Rob had a major contracture.

The next week when Rob was at school and I was picking him up he fell. I didn’t see him fall but he landed on the arm that had the surgery. He cried for a few minutes and then he appeared all right. I looked at his arm and it was bruised but I thought it was just from the surgery. We found out when he went to see the doctor 2 ½ weeks later that he had broken the plate and part of it was pushing up under his skin. The doctor said it would eventually have to come out but he wanted to leave the arm alone for another 4 weeks. During this time there was no more restrictions of motion for the arm. Robby was starting to use it more and more. I was really pleased with the results. Three weeks ago the plate started coming through the skin. I made an appointment with his doctor explaining what I was seeing. They said to come right in. When I got there they had already made arrangements for Robby to have surgery the next day to remove the plate. He must have been in quite a bit of pain with the plate coming to the surface but he just did not complain to me. He really must have developed a high pain tolorance. After the plate came out he was a totally different boy he started using the arm and fingers to point. He has been trying to cut meat with both hand something he could have never tried before. He even was feeling good enough that he told his teacher no about something and received a time out. Before he was always kind of quiet and slightly withdrawn. He is even contributing in school and is able to do some of the finger play now. Before he would just sit because he could not do them the right hand just wasn’t positioned properly.

Sorry to go on and on but this really for us has been the greatest improvement we have seen. I do however believe that all the other surgeries were just as important and with out them he would not be where he is now. I was really squeamish about the surgery but if I knew then what I know now I wouldn’t hesitate at all. That said each child is different and every brachial plexus injury is different I just know that it was the right thing for us to do.

I am glad this helped you. Rob has always had some movement in his hand especially his index finger and thumb but not much strenght. I think that has to do with he does not have much flexors (spelling?) in his wrist. I think what really helps is he can see his hand so that he knows what his fingers are doing. Good luck with Samantha, I will pray that this helps her as much as it has helped Robby.

Ruth