Neurosurgery Help!

[DCJenn]

Hey-

This is a question for those of you brave enough to be married (or whatever) to neurosurgeons from my very bestest friend.

Her daughter has Erb's Palsy and the neurologists that they've been seeing have recommended surgery. She'd like to talk to someone(s) who have experience with this type of surgery:

Here's her relevant information -

"Patricia sustained a brachial plexus injury to her right arm during childbirth. At birth, she could only move her right fingers and wrist. She regained bicep function at 2 1/2 months. Now, at 18 months, she cannot supinate past neutral and cannot externally rotate past 30 degrees. Our neurologist is recommending a muscle and tendon transfer surgery to give supination and external rotation. We'd like to see a few surgeons to get their perspective on the pros and cons, and we'd prefer folks who specialize in this sort of thing.

Thanks a million!"

and thanks from me as well!

Jenn

PS- Feel free to PM me as well. oh, they'll travel anywhere for a consult.

[Vanquisher]

Hi Jenn, this is Chad (Heidi's ortho monkey). She showed me your post, and I thought I would chime in. The surgeries that you are talking about (tendon transfers, etc.) are normally performed by orthopaedic surgeons (in particular hand and upper extremity surgeons). My experience with these is limited at this point, but there are a large number of procedures that can be done to restore various functions to the hand/arm after an Erb's palsy. Neurosurgeons do not typically do these surgeries so far away from the spinal cord. If they are discussing nerve explorations proximal to the shoulder or about the spine, then maybe.

My first advice to your friend would be to seek out a fellowship trained hand/upper extremity orthopod to get their opinion. Also, it may help to ask around among different surgeons, as different fellowships emphasize vastly different things.

Also, I will do a little digging to see what I can come up with. You can PM Heidi with the location that your friend is in because maybe we could help her out a bit with finding a few surgeons. Be careful whose opinions you get, do research, and make sure you are comfortable with your surgeon. Ask how many of these procedures they have done and outcomes. This isn't a really common surgery. Get a few opinions. Ask other surgeons who they would take their kid to, etc. At those consults, the surgeons who evaluate him should be able to go over pros and cons, expected outcome, risks, etc.

[SuzySunshine]

Jenn, I'm going to have my DH send you a PM.

[DCJenn]

Hi- We are in DC. They've seen docs at Hopkins and at Shriner's in Philly.

Any names would be appreciated, as well. Apparently the clinic at Texas Children's that used to do a LOT of these procedures has closed.

Jenn

[SuzySunshine]

Jenn, just an addition to my DH's e-mail. Dr. Spinner is the neurosurgeon here that would consult with the orthopods, but he's not sure if he does children. He's seen a case as young as 8 on his schedule, but not younger. Have they had any luck?