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Boy With Paralyzed Arm Going Home After Rare Microsurgery to Reroute Severed Nerves

Five-year-old Daryel Zarza is recovering beautifully after a rare, 12-hour-long operation at the Children's Hospital at Montefiore (CHAM) that successfully rerouted and spliced together damaged nerves in his paralyzed left arm.

The special surgical team used a high-powered neuromicroscope to help them tease apart and attach tiny nerves the diameter of a pencil lead, using sutures thinner than a strand of hair. Only a few medical centers in the United States have the expertise to carry out this kind of microsurgery.

"We are very happy with the results," said Renata V. Weber, MD, the plastic reconstructive surgeon who performed the operation. "Daryel is as rambunctious as ever this morning."

With his grandparents at his bedside, Daryel was celebrating his birthday in his balloon-festooned room. Grinning boyishly in his hospital-blue pajamas, he waved his good arm at visitors as he played with a slinky.

After leaving CHAM, Daryel will wear a shoulder sling for a couple of weeks to help his nerves recover. He'll then enter a physical therapy program.

Daryel's left arm was severely injured in a car accident that killed his parents in August 2005 on the Hutchinson River Parkway in New York City. While he has normal grasping capability in his left hand and wrist, he lost the function of his left elbow and shoulder because two spinal nerve roots were severed in the accident.

The microsurgery at CHAM successfully rerouted and attached portions of healthy nerves in his arm, neck and chest to the damaged nerves that control muscle movement in his elbow and shoulder.

"Nerves grow at about one inch per month, and because Daryel is small, he should recover sooner than an adult. I hope the nerves will grow sufficiently for him to use his elbow and shoulder muscles in six months to a year, " said Dr. Weber.

Daryel is living with his grandparents, Virginia and Carlos Veras, in their Bronx home. Daryel's aunt, Virginia Hernandez, was also with him at the hospital.

Dr. Weber was assisted by Vinod Pathy, MD, a first-year plastic surgery resident, and Michael Girshin, MD, chief of pediatric anesthesiology. The nursing team was headed by Sandy Lapin, RN.