United Brachial Plexus Network

This will be his 5th. Dr Nath said he is an excellent candidate for the triangle tilt so i am reading up on it as much as possible. Our date is Jan 10 in Houston. Anyone else going to be there?

Curiosity got the best of me...did the other 4 work?

Did the other 4 work? Hmmmm.
Primary of course to an extent.
Mod Quad also
Caps also to an extent
What I thought was going to be the Anterior capsule release? Well, his internal rotation is worse. His bicep contracture is also worse, his posterior subluxation? Yup, thats worse too. Before this surgery he could barely touch his eye and now he does have overhead pretty good but to what sacrifice? KWIM? I'm not looking for perfection. I know that would be virtually impossible but dang there are alot of trade offs with some surgeries sometimes. Which way do we go???

I have NO idea how to answer that.

We went the no surgery route and I wish I had reassuring words for you.

I hope all goes MUCH better with this one! You and your little man are in my prayers!

Mod Quad and capsulodesis were supposed to correct subluxation, so obviously they didn't work in that respect.

Do you know if Dr. Nath intends to do his version of the anterior capsule release on Aaron with his Triangle Tilt?

Kate

Kate yes he did say that we could def. discuss that. he is open to the ACR.

We saw Dr. Nath in August and he wants to RE-DO Alyssa's Triangle Tilt. She had the first one in May 2005 and lost all she gained from it. It just didn't sit well with me so I had a 2nd opinion with Dr. Hoffer about a week ago. He recommends we don't do anything at this time, and if anything in the future - an osteotomy. He said he has not read or saw anything for himself that what "needs to be done" (TT Re-do along with ACR) will work for Alyssa and help her shoulder socket re-form. He told me to "let her live" and if in the future, if SHE wants to do the osteotomy, she can choose to do it for herself.

Good Luck

Jody - mom to Alyssa (10) LOBPI

As far as the osteotomy goes-for me, that is a cosmetic fix and does nothing for the "mechanical" part. I would do that only as a last resort. but thats just me....

Paula, the osteotomy is done to give a child access to more function. Arm in a better position - certain movements may become more accessible. I personally don't look at it at all as a cosmetic fix - especially after meeting an 18 year old young woman who chose to have this done for specific functional reasons and I just got an email from her last night (a year later) and she's so happy with her "new arm" and all the new things she can accomplish now that she was never able to before.

Also, it may be that the osteotomy can help the shoulder in some way if where the bone is fractured the deltoid is rotated also. Different doctors do this differently - this is something you have to ask about.

Maia's arm is very internally rotated and if the day comes that she's so internally rotated that she can no longer do the things she can do now (play her instruments), then she will have a humeral osteotomy to set her back to where she is now and just slightly better.

I am hoping, however to bring some counter relief to this internal rotation problem by learning more about her muscles by using the myotrak unit. Maybe there's a way to put a halt to this internal rotation problem...I have no idea. One step at a time and an open mind - we're trying.

The osteotomy seems to do equally as much for the glenohumeral joint as the TT does. Remember the TT doesn't change any bones or anything within the actual GH joint either. It only rotates where the deltoids are attached at their origin (on the "tilted" triangle) so they are really quite equivalent in that respect. I would want to see proof that the TT somehow impacts the formation of the joint and normalizes it. There has not even been a suggestion that that is the case for TT and I don't really see how it would be possible.

Kate