Hi Laurie!
Hope all is well. I recently started seeing a 9 month old lab who was hit by a car. No broken bones but he did injure his brachial plexus and demo's severe "wrist drop". Doc feels the brachial plexus will fully heal. The owners currently are only putting a boot on the paw simply to protect it from scrape injury. I have been looking at the carpo flex wraps that I saw you recommended in another post for protection of the opposite leg - is this something that would give enough support to the affected side to stop the "wrist drop"? I also saw the post for the estim settings and will try that - where do you like to place the electrodes for best response? For a short time after laser to the axila and shoulder/scap area he does actually have good paw placement but this does not last very long and he soon goes back to totally curling his paw under and sliding or slightly touching down on the folded joint and I am worried he is doing more damage with this method. In the uwtm he doesn't attempt to step down with it and when I get in with him and move his leg for him to get good paw placement he gets really upset. Was going to order the carpo flex x today for him but am not completely convinced that this is going to help him like I want it to. What do you recommend? Thanks so much.
J.
Brachial Plexus Lesion
Brachial Plexus Lesion
LAURIE EDGE-HUGHES
Re: Brachial Plexus Lesion
Hi Jean!
Poor puppy! But the fact that he can occasionally place the paw correctly, I think, is good news and a good prognosis!
So, for the wrist drop - you’ll need to deal with TWO factors, 1) the collapse of the carpus and 2) the placement of the foot.
You’d have the option of a formal brace / orthosis that would do both at once - but since they are more costly, I usually look at those options for more permanent of long term cases.
To stop the carpus from buckling, any carpal brace will do - yes, I love the Carpoflex X. It is very versatile and you can add or remove varying support components, and the loop-neoprene fabric allows you to stick velcro stays, or velcro on some thermoplastic support, etc. All around, a very well thought-out product. (You can make a carpal wrap stiffer by adding padding, a velcro strap, or a thermoplastic support. It all depends on how much stability the carpus has.)
What you will need to add to whatever carpal support you choose, if a ‘foot placement’ mechanism. Options: Vet wrap the foot / toes ending at the toes so that you have a ‘tail’ of vet warp that you can pull up and hook to your carpal wrap (or wrap it around the metacarpal before you put a carpal wrap on). You could use some tape (i.e. stretchy kinesiotape / rock tape / K-tape etc) that you apply from toe nails (maybe even wrap under the nail or poke holes in the tape for the toe nails to go through) and then apply it ON STRETCH and affix it to the metatarsals / carpus or even onto the carpal splint. You could so something similar combining elastics an vet wrap… maybe hair elastics, they’d be more durable, and loop around each toe. You could use a bootie and put a hole in the toe end that would allow you to thread something through (i.e. vet wrap, a shoe lace, an elastic strap, etc) that you could then pull up on and adhere to the carpal splint. And if the foot has minimal tone / function, then you might want to make a thermoplastic splint that would go down the back of carpus and end in a scoop to hold the foot… then hold the foot in (and create traction) with vet wrap… HOWEVER, if the foot is not totally limp, then I think it would be good for it to have normal proprioception and be able to ‘feel’ foot placement.
I should do a video on all of these ideas! I’m hoping they sort of make sense in your head!
Then regarding e-stim, sounds like you’ll be wanting to look for / test / work with the carpal and digit extensors (Radial Nerve). So it’s really a matter of finding what works and remembering that your electrodes need to be on the same muscle (or in the case of these little muscles, the same GROUP of muscles). So just aim for the cranial aspect of the forearm! But just use it diagnostically. E-stim doesn’t do anything to speed up nerve regeneration or healing.
Best of luck!
Laurie
Poor puppy! But the fact that he can occasionally place the paw correctly, I think, is good news and a good prognosis!
So, for the wrist drop - you’ll need to deal with TWO factors, 1) the collapse of the carpus and 2) the placement of the foot.
You’d have the option of a formal brace / orthosis that would do both at once - but since they are more costly, I usually look at those options for more permanent of long term cases.
To stop the carpus from buckling, any carpal brace will do - yes, I love the Carpoflex X. It is very versatile and you can add or remove varying support components, and the loop-neoprene fabric allows you to stick velcro stays, or velcro on some thermoplastic support, etc. All around, a very well thought-out product. (You can make a carpal wrap stiffer by adding padding, a velcro strap, or a thermoplastic support. It all depends on how much stability the carpus has.)
What you will need to add to whatever carpal support you choose, if a ‘foot placement’ mechanism. Options: Vet wrap the foot / toes ending at the toes so that you have a ‘tail’ of vet warp that you can pull up and hook to your carpal wrap (or wrap it around the metacarpal before you put a carpal wrap on). You could use some tape (i.e. stretchy kinesiotape / rock tape / K-tape etc) that you apply from toe nails (maybe even wrap under the nail or poke holes in the tape for the toe nails to go through) and then apply it ON STRETCH and affix it to the metatarsals / carpus or even onto the carpal splint. You could so something similar combining elastics an vet wrap… maybe hair elastics, they’d be more durable, and loop around each toe. You could use a bootie and put a hole in the toe end that would allow you to thread something through (i.e. vet wrap, a shoe lace, an elastic strap, etc) that you could then pull up on and adhere to the carpal splint. And if the foot has minimal tone / function, then you might want to make a thermoplastic splint that would go down the back of carpus and end in a scoop to hold the foot… then hold the foot in (and create traction) with vet wrap… HOWEVER, if the foot is not totally limp, then I think it would be good for it to have normal proprioception and be able to ‘feel’ foot placement.
I should do a video on all of these ideas! I’m hoping they sort of make sense in your head!
Then regarding e-stim, sounds like you’ll be wanting to look for / test / work with the carpal and digit extensors (Radial Nerve). So it’s really a matter of finding what works and remembering that your electrodes need to be on the same muscle (or in the case of these little muscles, the same GROUP of muscles). So just aim for the cranial aspect of the forearm! But just use it diagnostically. E-stim doesn’t do anything to speed up nerve regeneration or healing.
Best of luck!
Laurie
LAURIE EDGE-HUGHES