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Small child having brachial plexus injury, right arm shorter than left. Botox shots suggested. Treatment?

I have a child who was born with a brachial plexus injury to her right arm 19 months ago. It was unresponsive until she was about 6 months of age. Now she can use it somewhat but nowhere near normal range. Through therapy she s been exercising but we re now noticing that the right arm is shorter than her left. What can we do? Is surgery advisable? Our neurologist suggested botox shots to relax the muscle to force her to use the arm with greater range of motion. Our concern is that it won t continue to grow. Help!
Asked On : Sun, 29 Jul 2012
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Pediatrician 's  Response
WHEN CHLID IS IN GROWING PERIOD AND NERVE INJURY OCCUR THIS LEAD TO DIMINISHED GROWTH ( POOR GROWTH ) OF THAT PART OF BODY ALONG WITH CONTRACTURE . WHEN ONE NERVE IS INJURED OTHER NERVE OVER GROW AND SOME PART OF ACTIVITY IS TAKEN BY THEM . SO YOUR CHILD HAVE SOME FUNCTION IN THAT HAND .
TO RELEASE THE CONTRACTURE BOTOX CAN BE USED SO THAT FUNCTIONAL ACTIVITY WILL INCREASE .
BY RHIZOTOMY ( MUSCLE SURGERY ) FUNCTIONAL ACITVITY CAN ALSO BE INCREASED .

IF THERE IS GROSS LIMB SHORTENING - LIMB ELONGATION WITH ELIZAROW METHOD CAN BE DONE BY ORTHOPEDIACIAN . BUT THIS IS LONG TREATMENT. CONSULT ORTHOPEDICIAN FOR THIS
Answered: Fri, 15 Feb 2013
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