United Brachial Plexus Network, Inc.

Kimberly,
Will your child still be able to supinate after this surgery? Do you have to go back to Dr. Davino to have the cast removed or can you do it with a local doctor if you live out of state? Thanks.

Yes, she will be able to supinate and pronate. It is just without the surgery, she was over supinated, therefore, she could not pronate very well. The osteotomy does not take any functions away. Just helps them.

Kimberly

we have just been advised to have a humerus osteotomy done for my daughter along with the tendon transfer (sever L' episcopo). has anyone had this done? what was the outcome? would love to hear any input.
A-

Kimberly,
Thank you so much, you have been so helpful and we appreciate it. Do you know if it is ok to get the cast off and X-rays done locally or does Dr. Davino have to do it himself? Also, with the pin removal, can someone else do it or do we have to go back to Houston. Thank you so very much. I hope that you don't mind answering these questions.

Guest,
Did you ever have the procedure done? It has been recommend for my daughter. Any information would be greatly appreciated.

Thank you

Dawn,

I think you are considering an osteotomy to rotate the arm inward to gain midline function and internal rotation? This is different than the customary useage of osteotomy (being discussed on this thread), which is typically used to rotate the arm outward from an excessive, fixed internal rotation position.

This "reverse" osteotomy to give children *more* internal rotation is becoming more and more common, as doctors are starting to recognize that lack of internal rotation can be very disabling and as that perhaps they have "gone too far" in trading internal rotation for external rotation and overhead motion.

The docs really have to come up with another term as it gets very confusing for parents!

Kate

Kate:
Juliana is scheduled for the "reverse" osteotomy, though the term the docs are using is "internal rotation ostetomy". The "traditional" osteotomy was always referred to as the "derotational osteotomy".

Shall we give it a nifty name?? I. R. O? hahahhahhaaa.

I agree, though, that we have to be clear about which osteotomy we have questions about. Forearm osteotomies are very different from the humeral osteotomies (in either direction).

claudia

I guess it should be called the "rotation osteotomy of the humerus" since the other is the "derotation osteotomy of the humerus".

It's so sad to hear of so many kids now needing this internal rotation "reverse" osteotomy. If anything, that glaringly shows that even when the different secondary surgery elements have been around for nearly 100 years (as in the tendon transfers and various muscle releases) changes in how and when they are applied and/or combined can have dramatic effects on outcomes. I hope to God *someone* is keeping track of the need for these revision surgeries!!

I'm sorry to hear Juliana needs this surgery; I truly hope it helps her out.

Kate

Hey, we are going for the forearm osteotomy in August as well and I was wondering--what does the scar look like? Sounds silly but I have read all the other posts and such but haven't seen this mentioned...

thanks

The scar from the forearm osteotomy is small. It is about an inch long horizontal line an inch or so above the wrist. There is also a small dot where the pin is put in. For a few months the scar was very noticeable and purple, but my daughters surgery was a year ago and you can barely see the scar at all now.