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Mod Quad Surgery
In order to use the hand effectively, the elbow becomes bent, and this eventually becomes fixed because of weakness of the triceps (the elbow straightening muscle). The elbow-bent posture (also known as the Erb's Engram) contributes to the appearance of the arm being shorter, although it probably is in reality not much shorter when measured. For this muscle imbalance, there is a very effective group of muscle releases and transfers which can put the arm in a more natural position and help to lift the arm over the head. We refer to this operation as the "quad" procedure because it has four components:
We have performed the quad procedure on thousands of children and adults with Erb's palsy and have been very excited about the degree of movement that is gained. On the average, we find a 70 degree improvement in abduction and 60 degree improvement in external rotation at 6 months after surgery; these results should also improve with time. We find that the best time to do this procedure is 1 to 2 years of age, but we have been very successful with older children and adults as well. |
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