United Brachial Plexus Network, Inc.

Recently a Dr. told us that the bicep lengthening procedure could cause some loss of the ability to supinate the hand. My child would much rather have a hand that turns over, than a perfectly straight arm. Can anyone enlighten me from their experience? Thank you, Nancy.

Nancy S.

I am an adult/obpi and the greatest loss for me was the inability to supinate. I never had any surgery. I am 63 and I think that is a very important life function. My arm appears to hang and is shorter etc by my hand is pronated and I was 50 the first time I got my hand to neutral and that was exciting. Just my personal opinion I still would love to supinate.

Kath

I am a 64 year old ROBPI and would echo Kathleen's comment. I can suplinate to about 10 degrees. Suplination is such an important hand function. If the surgery objective is help make the arm look "normal" then I agree that loss of other hand function should be carefully considered. Are there other benefits to be gained from surgery?

Sounds like your daughter may be partipating in the decision making process. Guess the basic question is "Is she happy with the function and "form" that she has now?"

John P.

Biceps does play a huge role in supination and there is the risk that a biceps tendon lengthening can cause some weakened biceps or even loss of biceps if it's done incorrectly.

I guess the important questions to ask your surgeon would pertain to permanent losses... how many permanent losses - what are the chances of having a permanent loss. What are the long term issues if you do it or don't do it...etc.

maia did have this surgery in May and she has major increase in function - not decrease. You have no idea what a straight arm has given her. She can't supinate now - but she couldn't supinate before either so it's not a loss for us. And that is why only YOU know the right answer for your child. I guess a lot depends on the severity of the contracture. You have to weigh the odds of both.

Good luck making this decision, it's a tough one, but aren't they all, really,

francine

What exactly is the bicep lengthening then doing to help? I thought it was in correlation with the osteotomy and found out it is not. I was told to have the osteotomy first and someone else was told to have the bicep lengthening first? Does anyone know why there would be a difference in order? I too would love to suppinate. With my elbow close to my body I can turn my hand to suppination position, however when I stretch my arm outwards in front of me, I can only suppinate about half way. Help!!
Thanks

This website is amazing to me. Ask for information, help, advice and you receive. Thanks for your responses! My daughter (14) has a very mild contracture of her right arm. Our focus for her is more about increased supination than it is about straightening. As she grows, the limited hand function is the thing that bothers her most. So many things to think about.

Please share some infomation with me. I would like to know if pronation and supination can come back naturally without surgery? If so, when?

Dave - are you wondering about a baby? You should know that in the developmental scale for a baby without an injury, supination comes in around 11 months. In terms of what movements come in when -- there's no way to define this. Too many variables in a child with a bpi.

Nerves grow one inch a month from the spinal column down - and that number slows down as the child gets older and it also slows down the further away from the neck it gets.... extremely variable.