ERB'S PALSY BRACHIAL PLEXUS INJURY

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What is Erb's Palsy?

Erb's Palsy also known as Brachial Plexus Palsy or Shoulder Dystocia is an injury to one or more of the five nerves running from the cerebral vertebrae of the spinal cord to the arm. These five nerves make up the brachial plexus and are responsible for supplying feeling and movement to the arm muscles. Erb's Palsy causes partial or complete paralysis of the arm.

Types of Brachial Plexus injury include:

• Erb-Duchenne Palsy Duchenne-Erb's Syndrome
• Erb's Paralysis Upper Brachial Plexus Paralysis, Erb-Duchenne Type
• Erb's-Duchenne Paralysis Upper Brachial Plexus Palsy, Erb-Duchenne Type
• Duchenne-Erb's Paralysis Brachial Plexus
• Duchenne's Paralysis Brachial Plexus Neuromas
• Klumpkes Palsy

What causes Erbs Palsy/Brachial Plexus?

Erb's Palsy is a birth injury in which the shoulder, head or neck are damaged during a natural childbirth.  Commonly resulting from a breeched birth, a complication where the baby is delivered hind end first, it is possible for the baby's shoulder to become stuck on the mother's pelvis bone. In such cases, the physician will have to use traction in order to dislodge the baby. If too much traction is applied upon freeing the baby, the excessive force and stretching of the plexus nerves can cause the shoulder to become dislocated, resulting in what is known as Shoulder Dystocia, which can cause Erbs Palsy in the child.  Statistically, one in every one thousand births will cause trauma to the brachial plexus and one in every ten of those injuries will be serious enough to require medical treatment.

In many cases a brachial plexus injury at birth may have been caused by medical malpractice or physician error during a complicated vaginal delivery.  Emotional and physical suffering caused by an Erb’s Palsy injury can have an impact on the child throughout their entire lifetime. Contact Johnson City medical malpractice and Cerebral Palsy Attorneys of Evan Meade and Associatesfor legal advice regarding your specific case needs.

What are the Types of Nerve Injury Associated with Erbs Palsy?

There are 4 types of nerve injuries.

1.  Neurapraxia - a severe pulling or "shock" to the nerve; however, there is not a tear associated with this injury.  This injury usually does not require treatment and often will regenerate itself within three months.  This is the least severe of nerve damage.

2.  Neuroma - a stretch injury where some (but not all) of the nerve fibers are torn.  The torn fibers will repair themselves, yet scar tissue can result which will press on the undamaged nerve fibers and potentially cause complications.  There will never be a complete recovery of the damaged nerve; however, there will be some.

3.  Ruptured Nerve - a stretch so severe that the nerve is torn apart.  A ruptured nerve will not repair itself.

4.  Avulsion - the most serious of nerve injuries which occurs when the nerve is torn completely away from the spinal cord.  There is possible surgical reconstruction through nerve graft, where a donor nerve is spliced and borrowed from another muscle in the body.  Some feeling and use of the arm may be recovered through the intricate nerve splicing process.

What are the Symptoms of Erb's Palsy Birth Injuries?

Loss of feeling and use of the arm can occur with each type of nerve damage, the severity of the damage will usually define the severity of the injury.  Partial or complete use of the victim's arm and hand are lost and the affected limb often appears to be hanging limply at their side.  Usually shoulder flexion is lost and the arm can not be lifted above the head.  Hand use and gripping are often very limited while the hand itself may appear to rotate inward and upward.

How are Brachial Plexus Birth Injuries Treated?

There are two types of treatment for Brachial Plexus injuries:  surgical and non-surgical.

1.  Non-surgical Treatment - This treatment involves Physical Therapy and thorough range of motion (ROM) exercises performed by parents multiple times through out the day.  This will aid in loosening the joint and avoiding joint contracture, a permanent stiffness or "freezing" of the joint.

2.  Surgical Treatment - Physicians can opt to perform surgery on the damaged nerves after three to six months of ineffective non-surgical therapy.  In cases where multiple nerves are involved, more surgeries will be necessary to repair the damage.  The lower the damage is on the arm (below the elbow), the less likely recovery will be due to the further distance that the nerve has to travel to the effected area.

If medical malpractice during childbirth caused Erb's palsy for your child, contact Tricities Tennessee birth injury lawyers of Evan Meade and Associates for assistance with your case.