Erb’s Palsy Affects Infant Mobility

What is Erb’s Palsy?

Erb’s palsy is a brachial plexus injury. It most commonly occurs at birth. The brachial plexus is the network of nerves that provides sensation and movement to the arm, hand, and fingers. In other words, it is this nerve plexus that connect the brain to the arm and the hand.

Brachial nerve injuries are classified according to severity. The severity of the injury dictates the type of treatment and the prognosis for recovery. Symptoms of brachial plexus injuries include:

• Arm movement with little or no use of hand and wrist.

• Hand movement with no use of shoulder or elbow.

• No feeling (paralysis) in the arm or hand.

Erb’s palsy is diagnosed after birth and is characterized by an arm laying straight down at the side and does not move. Sometimes the arm is turned, the wrist bent, and the fingers straight. If a droopy eyelid is also observed on the same side of the body, this usually indicates more severe nerve damage.

How it happens?

About two out of 1,000 babies born by vaginal birth suffer brachial plexus injury. These injuries occur when the baby is passing through the birth canal. If pressure is exerted on the baby’s neck or shoulder during birth which causes the neck to stretch, the brachial nerves can stretch or tear. Brachial plexus injuries occur most often during difficult deliveries involving a large baby, a prolonged labor, or a breech presentation. Although larger than average babies are at higher risk, babies of any size, including premature babies, can have this injury. Shoulder dystocia is a leading cause of brachial plexus injury. It occurs when the baby’s shoulder get stuck behind the mothers pubic bone during delivery.

Treatment

Physical therapy and surgery are the two treatment options used for Erbs palsy. Physical therapy exercise is usually the first option.

Physical Therapy

Physical therapy exercises are essential for keeping the baby’s joints and muscles active. Involvement of a parent or a caregiver is critical in the recovery of the baby. The range of motion exercises must be done daily or even two to three times per day. This treatment is most effective when initiated early, at about three weeks of age. Most babies recover fully but it may take up to one or two years with consistent physical therapy. Babies with Erb’s palsy should be re-examined after one and three months to assess progress.

Surgery

If babies do not recover some motor function between 3 and 6 months surgery is an option. It is worth noting that nerve surgery may help babies less than a year old, but it does not help infants over one year old. After nerves are surgically repaired at the neck, the rate at which nerves grow (about one inch per month) means it could take several months or even years for the repaired nerves to reach the muscles of the hand. When children get a little older and continue to have weakness in the shoulder, arm, or hand, additional surgery - tendon transfer surgery - may be helpful. Tendon transfers are normally done when children are old enough to follow post-operative instructions. Surgeries are typically followed up with physical therapy for several months or up to a year.

In some cases of Erb’s palsy, the growth of the affected arm is impacted and appears noticeably smaller than the other. In these cases, adjustment to any functional limitations must be learned and self-esteem issues should be handled appropriately.

Prevention

Many believe that prevention is best accomplished by increased awareness and education about safe and effective protocols for handling shoulder dystocia, a main cause of brachial plexus injury.

If your child suffers from Erb’s Palsy and you believe it to be the result of medical malpractice or negligence, you may have a valid legal claim. Contact an experienced family law attorney for more information on a potential Erb’s Palsy lawsuit.

(Article from Birth Injury and Medical Malpractice Legal View)