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Canada BPI Specialists/Clinics
Dr Patricia Egerszegi, Plastic Surgeon
When was your Brachial Plexus Injury Clinic established? 2000 Identify what specialties related to brachial plexus injuries are represented by practitioners working in your clinic including physical/occupational therapists, if any. Our clinic works as a multidisciplinary clinic. The medical specialties are: plastic surgery, orthopedic surgery and physiatry. Our rehabilitation team is composed of physical therapists, occupational therapists and a social worker. If necessary, a psychologist and a special educator are included in the team. What do you/your clinic specialize in treating?
Indicate the total number of brachial plexus patients you/your clinic has evaluated since your establishment: Number of children (Obstetrical brachial plexus injuries): Approximately 300 Number of children (Trauma or other brachial plexus injuries): 5 Number of adults (Obstetrical brachial plexus injuries): 0 Number of adults (Trauma or other brachial plexus injuries): 0 State your philosophy regarding evaluation, referral and treatment of obstetrical brachial plexus injuries in children. Our clinic encourages early referral of newborn babies. They are seen by a physiotherapist for an evaluation and parental education regarding positioning and stretching. The gross motor development of the babies is also followed closely. The children are also initially evaluated by a physiatrist and if at about 3 months of age the absence of movement persists, the child is seen by the surgical team. Our surgeons will, along with the physiotherapists and the parents decide whether a reconstruction surgery is necessary and appropriate. A complete investigation is then done including MRIs, Myelo-Scan, Fluoroscopy of the diaphragm, etc. If a surgery isn't indicated at this point, the children continue to be followed closely and are re-evaluated by the surgical team at 9 months of age. At this point, other types of surgeries are often performed the most common of which is a nerve transfer. Again, after this, the children continue to be followed closely. An occupational therapist generally becomes involved at this age as the fine motor skills develop. Later on , different types of orthopedic surgeries can be suggested depending on the development of the child. The strength of our clinic is the multidisciplinary approach and the fact that it combines the medical advantages of an acute care hospital as well as the support and the philosophy of a rehabilitation centre. This enables us to follow the children on a long term basis and intervene when necessary. Indicate research efforts (include dates please) conducted by you/your clinic specific to brachial plexus injuries. Since our clinic, in its actual form, is fairly young, we haven't yet developed a research project. Our time so far has been devoted to the development of educational material for parents, elaboration of our evaluation protocols, etc. Our next step is research! Do you accept any national/governmental payment for services or are you enrolled in any state Medicaid plans? Please provide information on these plans and include which states you are enrolled in for Medicaid services. In Canada, our health services are public, funded by the government and therefore available to all. |
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