Elbow: Fractional
lengthening of the biceps and brachialis
Forearm: Pronator
re-routing
Wrist: Flexor
carpi ulnaris to extensor carpi radialis (FCU>ECRB)
Thumb: Adductor
release with EPL re-routing.
Many patients have a few procedures at the same
time. The immediate benefits
of this are having one anesthesia, one cast and
one interruption to everyday life. The functional and rehabilitative benefits
are that the patient can practice using the new motor patterns and muscle
forces at one time rather than learning one and then another and then another.
Depending on the type of tone and the rate of growth, “tune up” procedures
are sometimes indicated. Your team can best let you/your child know the
likelihood of this. The “tune up” procedures are in a minority of the
patients. These procedures are also less intensive and often done on an
out-patient basis. Below is the anatomical diagram of the problematic areas
most often addressed together. Your plan may vary.
