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There are many ways you can help children and their families get the care they need.
Children who continue to have problems after they’re 3 to 6 months old may benefit from one of several surgical options.
(10 to 20 percent of all brachial plexus birth palsy surgery)
• Recommended if recovery is still inadequate three to six months after birth
• To repair or reconstruct the injured nerves
• Can be “nerve grafts,” usually from the leg (sural nerves) between nerve root and nerve to muscle
• Can be “nerve transfers” from other areas of the brachial plexus (or other areas of the body): for more serious
brachial plexus birth palsy (avulsion)
• Nerve reconstruction is best performed between 3 and 9 months of life and is usually not beneficial for children
beyond 1 year of age
• Involves separating the tendon from its normal attachment and reattaching it to a new location
• Allows a healthy muscle to help a weaker or injured muscle perform its desired function
• Usually performed around the shoulder to improve the ability to raise the arm, but may be used in forearm,
wrist or hand
• Done between 1 year of age and adulthood
• Patients usually in a cast for four to six weeks after surgery
• Extensive post-operative therapy
• In some cases, shoulder weakness may cause limitations in motion that aren’t amenable to tendon transfers
• Reducing (placing the humeral head back in joint) and surgically tightening loose tissue around the shoulder
• Usually performed when persistent muscle weakness has caused shoulder joint instability or dislocation
• Performed through a surgical incision (“open”) -or- using arthroscopy (pencil-sized camera is inserted into the
shoulder via smaller incisions)
• Often performed in conjunction with other surgical procedures
• Procedure in which bones are cut and reoriented
• May improve upper extremity function by better positioning the hand and arm
• Most commonly performed on the humerus (upper arm bone) or forearm
• Typically using muscle (gracilis) from patient’s leg(s)
• Extensive surgery requiring reconnection of blood vessels and nerves under microscope
• Used only when there are no local muscles in the arm or hand to replace dysfunctional muscles
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”