United Brachial Plexus Network, Inc.

Your PT can make a splint for you to wear at night.

7 years and no claw hand. I def. exercised and flexed them all the time, but have not recently.

Hiya...I am 12 years post injury and my fingers are not clawed, never even started to. I think the reason for this is the severity of my injury...I have never really done any proper excercise to my fingers, so that can't be the reason why they are so flat.

Lizzy B

Like Liz says depends on how bad the nerves were injured, if there gonna curl theyll curl nothing you can do realy

Here's a site that describes the causes pretty well, it's from C8/T1 involvement http://neurosurgery.ucla.edu/Diagnoses/ ... Dis_1.html funny that some people get Horners but not claw hand despite the cause being involvement of the same nerve root.
What about which way your hand faces? Mine is palm up with the thumb facing outward, I know that when it's facing the other way, palm backward,(called waiters tip) that's indication of a less severe injury, upper trunk nerves only, but why the muscles and things make it face frontwards in whole plexus injuries I don't know. Do all of you with whole plexus involved injuries and similar recovery to me (ie nothing but biceps) have palm up hands?????

We need photos :0)
Jen NZ

Nope...another anamoly for you Jen..my hand, when standing straight and the arm is just hanging there, faces the side of my leg. When sitting, it naturally falls onto my lap palm upwards, but if I turn it over with the other hand, it'll quite happily stay there instead. It's probly why my arm and hand fools most people...it looks completely natural to the untrained eye.

Lizzy B

well that's weird Liz! My understanding is that it's lack of biceps that makes the hand face in the waiters tip position as in erbs palsy, and I thought that because I only have biceps and nothing else (agonist and antagonist???) and it's biceps that makes it face upwards, that's why mine's stuck this way. It didn't go this way until my biceps came back, it gradually happened as the biceps got stronger. So did your graft maybe fix whichever muscle opposes the biceps action as well as biceps which would enable your arm to be neutral as it seems to be?? Or maybe your biceps isn't strong enough to pull the arm into the palm up position-I did use mine lots when I was a new mum so maybe it's stronger than yours. If only we had lower arm and hands we could arm wrestle and sort it out!

All interesting stuff. Katep, if you read the tbpi boards please explain everything :0)

Right...I'm standing up, now flexing the bicep (only muscle I have innervated) and as my hand raises up slowly, the palm turns upwards, like I'm asking for a hand-out!

Let it go again, and its back alongside my leg, palm facing in. So, I reckon your theory is right...my bicep isn't as strong as yours and this is prolly why my arm presents itself this way.

This thread is way cool...everyone seems to be different ever so slightly where this is concerned...just like every other aspect of this injury, ay?

Lizzy B

Jenny,

I just wanted to interject here because my daughter, Emma (ROBPI), had deltoids and biceps and nothing else--let me back up, first she had nothing and by 9 months of age she had some biceps and deltoids and a tiny bit of finger movement (on 3 fingers--pinky, ring, and middle).

She presented in the "classic waiter's tip" except when she started using the biceps and she would pull up her arm, but the wrist was still in the waiter's tip position. Once she had her surgery (at 13 months) they found she had a total plexus injury. C7 was avulsed, C5 and C6 handing by a thread and covered in scar tissue and the rest over stretched beyond ever going back. She also has slight horner's (which is now only noticeable when she is over tired or sick).

So, my understanding is that all the nerves have a basic function, but they all help each other out and it depends on the point of injury and exactly how they are injured ~ then how they heal:
do they go back together properly; do they form massive scar tissues at injury site/surgery site; or do they connect back in places that they wouldn't have normally been?
I've only been dealing with this injury for 9 years; I'm sure some of you know more and can add more, but I just wanted to share Emma's presentation of the injury.

Peggy