Health Law

"New" Erbs Palsy Surgery

"New" because it's a surgery that has been around for years but only recently has been used for children.  The surgery involves reconnecting broken nerves to healthy ones.  Now repair can be done on young people before the injuries get to a point of no possible repair. 

Ella Woodruff is a three-year old who suffered an injury that left her left arm paralyzed and broke a bone in her neck.  Today she is almost back to normal because of this  surgery that was done at St. Louis Children's Hospital.

Dr. Susan Mackinnon, chief of the division of plastic and reconstructive surgery at Washington University's School of Medicine, summed up the results: "Spectacular. That's the adjective I would use."

Because of Ella's response to the surgery, physicians are holding high hope that the procedure could be used on children as young as three months.  They think that Ella's great response is due to her age and that her developing body was able to cooperate better with the surgery.

Erb's Palsy is an injury to the brachial plexus, a cluster of nerves that connects the arm and hands to the brain.  The injury often occurs during childbirth when the baby's shoulder gets stuck in the birth canal and too  much force is used in trying to free the baby.  The severity of the nerve damage determines whether healing occurs naturally or whether surgery could be used.

The old surgical method involved grafting a healthy nerve from some area of the body to the damaged nerve.  Ella's physician Dr. Gregory Borschel, a pediatric plastic surgeon with Children's Hospital, has said that this method has downsides such as leaving a part of the body numb since it has no nerve connection.  The recovery is also much slower.
 

"We did something called a nerve transfer, often a better option in pediatrics," he said. "Think of it as a bypass."

During a six-hour microsurgery, he cut the crushed nerve that exchanged messages between Ella's hand, arm, shoulder and brain and reconnected it to a healthy, redundant nerve — one that didn't have much to do.
 

As for Ella's recovery, "It was almost like nothing had happened," Borschel said. "Based on how rapid her recovery has been … she will likely max out our measurement scale."
 

Full post as published by Cerebral Palsy Law Blog on October 21, 2008 (boomark / email).