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Treating brachial plexus injuries
Tuesday, August 21, 2001
Ninety percent of birth injuries to the brachial plexus will heal within a few days to six months. The rest don't.
"We were willing to go anywhere. To do anything. But, we didn't know what to do," said Pattye Stragar, recalling her desperation following the birth of her son David.
Their quest led them to a pediatric physical therapist familiar with the Children's Hospital Brachial Plexus Clinic, which opened about five years ago. It is one of a handful of treatment centers in the United States and treats 100 to 125 patients a year.
Although brachial plexus injuries can occur in accidents or from a breech birth, most are due to shoulder dystocia delivery, says Dr. David Adelson, the clinic founder.
Here, the doctors perform brachial plexus surgery on children as young as 6 to 9 months, removing scars and adding nerve grafts.
Clinic staffers monitor David's physical therapy, and, on his own, he swims and plays baseball, basketball and hockey to help improve his range of motion.
During an examination in May, Adelson asked David to raise his arms above his head. His right arm isn't quite as straight as his left. From behind, Adelson notes that he still has a "winging" where the scapula juts out more on the right side.
"It's summer. That means playgrounds -- and lots of monkey bars," Adelson says, noting that climbing would be good therapy for his arm.
Sometimes surgery is necessary. Adelson's next patient that day was 3-year-old Aaron, son of Jammie Lockwood.
Aaron weighed 9 pounds at birth.
"Before the surgery, Aaron couldn't lift his hand above his belly button. It turned away from his body, and he held it in the same position, slightly bent, as if it was in a sling, and you took off a sling, and the arm fell a little bit," Lockwood said.
Aaron had his first surgery after his first birthday and can now lift his arm to his shoulder. Another surgery was planned this summer to clear scar tissue on the back of his arm so he could move his arm above his head.
"I am very pleased with the progress my son has made," Lockwood said. "What they were shooting for in actual movement has been exceeded."
-- Jane Miller
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