Presents in a newborn with decreased movement of the involved arm, usually in the 'waiter tip' position.
Typically recovers over the course of the first 6 to 12 months of life.
Physiotherapy or occupational therapy is used in children with brachial plexus birth palsies in order to maintain motion and prevent contracture as the nerves reinnervate muscles affected by the initial injury.
Nerve reconstruction or muscle transfer surgery may be needed to improve function in children with incomplete recovery.
A type of brachial plexus birth palsy (a paralysis of the upper extremity due to an injury to the nerves that control movement and sensation to the upper extremity occurring at the time of birth). Often encountered as a consequence of a delivery complicated by shoulder dystocia, Erb's palsy typically involves the C5 and C6 nerve roots.
History and exam
- crepitance of clavicle or humerus
- Horner's syndrome
- tachypnoea, respiratory distress, feeding difficulties, failure to thrive
- lack of full range of passive movement
- hyper-reflexia, persistent primitive reflexes, abnormal muscle tone, or abnormal body posture
Brachial Plexus Treatment Center
Assistant Director of Pediatric Orthopedic Research
Akron Children's Hospital
MJA declares that he is on the speakers' bureau for Orthopediatrics implant company and has received compensation to the Department of Orthopaedic Surgery at Akron Children's Hospital for his involvement. He declares that there is no relation of this agreement to the topic of his BMJ article.
Assistant Professor in Child Neurology and Developmental Pediatrics
1st Department of Pediatrics
Aristotle University of Thessaloniki
DIZ is an author of a reference cited in this monograph.
Professor of Orthopedic Surgery
UT Southwestern Medical School
Director of Hand Surgery
Texas Scottish Rite Hospital for Children
ME is an author of a number of references cited in this monograph.
Hand and Upper Extremity Surgeon
Shriners Hospitals for Children
SHK is an author of a reference cited in this monograph.
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