Brachial Plexus and Erb’s Palsy Injuries: Essential Knowledge for Prevention and Treatment

What is Brachial Plexus Injury or Erb’s Palsy?

The brachial plexus is a complex network of nerves responsible for the communication between the spinal cord and the muscles of the shoulder, arm, and hand. A brachial plexus injury occurs when these nerves become damaged, leading to partial or full paralysis in the affected muscles.

This type of injury often occurs at birth when an infant’s shoulder becomes trapped in the mother’s pelvic bone, known as shoulder dystocia. Medical professionals might need to apply force to the baby’s head or upper body to facilitate the delivery, which can result in damage to the brachial plexus nerves. These birth-related injuries are sometimes referred to as Erb’s palsy. Approximately 1 to 2 babies per 1,000 experience brachial plexus injuries at birth, with many of these cases being preventable.

The severity of a child’s disability depends on which nerves are affected and the extent of the damage. Symptoms may include the following:

  • A limp or paralysed arm
  • Inability to use shoulder or elbow muscles
  • Limited control over the wrist and hand
  • Absence of muscle control or feeling in the arm or hand

There are four types of brachial plexus injuries:

  1. Neuropraxia or stretch injuries vary in severity from mild, with the potential for early recovery, to complete paralysis with no recovery potential. These injuries are typically caused by the nerves becoming compressed due to swelling and bruising.
  2. Neuroma injuries involve scar tissue compressing nerves as they attempt to heal, disrupting nerve signal conduction. Surgery may be necessary to remove the scar tissue and restore proper nerve function.
  3. Rupture injuries occur when the nerve is torn, potentially in multiple locations, but not at the spinal attachment. Surgical intervention, including nerve grafts, and therapy are required to restore normal function.
  4. Avulsion injuries involve the nerves being pulled or severed from the spinal cord. This is the most severe type and requires extensive surgery, such as muscle transfers, to restore function.

Negligent care during pregnancy, labour, and delivery can lead to brachial plexus injuries. Instances of negligence include failure to accurately estimate the baby’s weight, failure to determine if the baby’s shoulders are too large for the birth canal, and applying excessive lateral traction to the foetal neck during delivery. If you suspect your child’s brachial plexus injury resulted from inadequate care provided by a medical professional, it is important to seek legal advice from experienced solicitors.

Rehabilitative care for children with brachial plexus injuries may include physical therapy and occupational therapy. In some cases, surgical treatment such as nerve grafts or muscle transfers may be necessary to improve functionality.

Below are some examples of negligent care on the part of doctors, nurses and other health care providers that can result in brachial plexus injuries.

  • Failing to properly estimate the weight of the baby.
  • Failing to determine that the baby’s shoulders are too large to fit through the birth canal.
  • Applying excessive lateral traction to the foetal neck during delivery.

If your child has suffered a brachial plexus injury and you suspect that the injury resulted because a doctor, nurse or other health care provider failed to provide adequate care during the pregnancy, or during the labour and delivery of your baby, please contact us for advice from our team of experienced solicitors.

We will help establish whether or not there has been medical negligence in which case we will assist you in recovering compensation that can be used for your child’s care and education.

Frequently Asked Questions

What are the differences in symptoms between Erb’s palsy and Klumpke’s palsy?

Erb’s palsy primarily affects the upper arm and may cause weakness, limited range of motion, and partial or complete paralysis. On the other hand, Klumpke’s palsy affects the lower arm, hand, and fingers, with symptoms including weakness, lack of sensation, and possibly a characteristic “claw hand” deformity.

What are the typical treatment methods for Erb’s palsy?

Management of Erb’s palsy typically begins with conservative treatments such as physiotherapy and splinting. If the condition does not improve, other treatments like nerve grafts or transfers may be considered.

What are the main causes of Erb’s palsy in newborns?

Erb’s palsy can be caused by birth trauma, such as forceful pulling or stretching of a baby’s head and neck during childbirth or complications related to shoulder dystocia.

Which nerve is typically impacted in Erb’s palsy cases?

The most common nerve affected in Erb’s palsy is the C5 nerve, which is part of the brachial plexus network of nerves in the neck and shoulder area.

What are potential long-term consequences of brachial plexus injuries?

Individuals with brachial plexus injuries may experience long-term effects such as weakness or loss of function in the affected arm, hand, or shoulder, as well as chronic pain and sensory loss.

What circumstances are most likely to lead to a brachial plexus injury?

Brachial plexus injuries can occur during situations such as childbirth complications, motor vehicle accidents, sports injuries, or other traumatic events involving forceful impact or stretching of the neck and shoulder area.

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