Erb's Palsy
Original Editor - Your name will be added here if you created the original content for this page.
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Clinically Relevant Anatomy
[edit | edit source]
Erb's palsy or Erb–Duchenne palsy is a paralysis of the arm caused by injury to the Brachial Plexus, specifically the upper brachial plexus (C5-C8).
Mechanism of Injury / Pathological Process
[edit | edit source]
The most common cause of Erb's palsy is dystocia, an abnormal or difficult childbirth or labor. For example, it can occur if the infant's head and neck are pulled toward the side at the same time as the shoulders pass through the birth canal. The condition can also be caused by excessive pulling on the shoulders during a vertex presentation (head first delivery), or by pressure on the raised arms during a breech (feet first) delivery. Erb's palsy can also affect neonates affected by a clavicle fracture unrelated to dystocia.
A similar injury may be observed at any age following trauma to the head and shoulder, which cause the nerves of the plexus to violently stretch, with the upper trunk of the plexus sustaining the greatest injury. Injury may also occur as the result of direct violence, including gunshot wounds and traction on the arm, or attempting to diminish shoulder joint dislocation. The level of damage to the constituent nerves is related to the amount of paralysis.
Clinical Presentation[edit | edit source]
This type of injury produces a very characteristic sign called Waiter's tip deformity due to loss of the lateral rotators of the shoulder, arm flexors, and hand extensor muscles. The position of the limb, under such conditions, is characteristic: the arm hangs by the side and is rotated medially; the forearm is extended and pronated. The arm cannot be raised from the side; all power of flexion of the elbow is lost, as is also supination of the forearm
Diagnostic Procedures[edit | edit source]
add text here relating to diagnostic tests for the condition
Outcome Measures[edit | edit source]
add links to outcome measures here (see Outcome Measures Database)
Management / Interventions
[edit | edit source]
Some brachial plexus injuries may heal without treatment. Many children who are injured during birth improve or recover by 3 to 4 months of age. Treatment for brachial plexus injuries includes physiotherapy and, in some cases, surgery.
Differential Diagnosis
[edit | edit source]
add text here relating to the differential diagnosis of this condition
Key Evidence[edit | edit source]
add text here relating to key evidence with regards to any of the above headings
Resources
[edit | edit source]
add appropriate resources here
Case Studies[edit | edit source]
add links to case studies here (case studies should be added on new pages using the case study template)
Recent Related Research (from Pubmed)[edit | edit source]
Failed to load RSS feed from http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1vaAFBuRYujy70p_h7cTIdw09aj2lbrFNl1Lpz6Ct2PwUstQMj|charset=UTF-8|short|max=10: Error parsing XML for RSS
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
