Erb’s palsy is a kind of spinal cord, nerve root paralysis that happens during pregnancy. It refers to damage to the nerves that control the upper arm. The infant’s arm hangs limply from the shoulder with flexion of the wrist and fingers due to weakness of muscles. The injury is caused by pulling on the shoulders of the infant comes out head first, pressure on the arms in a breech position, or pulling to the side of the infant’s head as it comes out of the birth canal. An infant’s neck is extended to the side during a troublesome delivery. It is a lesion of C5 & C6 nerve roots (in some cases C7 is involved as well) usually produced by widening of the head shoulder interval. The nerve root may be stretched, burst, or separated because of the injury. This occurs sometimes in infants due to injuries to nerves during childbirth. One or two of each 1,000 babies have this condition.
Risk factors.
Shoulder dystocia – a birth injury that happens when one or both of a baby's shoulders get stuck inside the mother's pelvis during labor and birth.
Fetal macrosomia - a newborn who's much larger than average.
Maternal obesity – overweight of a woman during pregnancy
Gestational diabetes - high blood sugar that develops during pregnancy and usually disappears after giving birth.
labor goes on for a long time.
Breech presentation.
Features.
Waiter's tip deformity.
lack of reflexes on the affected side.
No movement in the arm or a part of the arm.
Minimal grip strength in the affected hand.
If the condition is not detected until later, the child may experience weakness, loss of feeling, or partial or total paralysis in the arm.
A thorough history and physical examination with a focus on neurologic examination are used to confirm the diagnosis. Many children who are injured during birth improve or recover by 3 to 4 months of age, although it may take up to two years to recover.
Fortunately, between 80% to 90% of children with such injuries will attain normal or near-normal function.
Physiotherapy management.
️ Treatment for Erb’s palsy includes physiotherapy and, in some cases, surgery.
️ Physiotherapists play a main role in preventing fixed deformities, recovering movement and muscle strength, reducing stiffness and pain, preventing secondary complications, and maximizing function.
References
https://www.cerebralpalsyguidance.com/birth-injury/erbs-palsy/ https://orthoinfo.aaos.org/en/diseases--conditions/erbs-palsy-brachial-plexus-birth-palsy
Sankalani de silva.
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