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Erb’s palsy or Erb-Duchenne palsy is paralysis of the arm due to
damage to the brachial plexus, a group of nerves running from the neck to the armpit region. During
a difficult birth, these nerves can be injured, causing what is called
brachial plexus birth palsy. When the upper branches of the brachial plexus
are injured, it results in Erb’s palsy. This is the more common
brachial plexus birth palsy, and results in an inability to move the shoulder.
As opposed to those with “global” or “total” brachial
plexus birth palsy, in which both the upper and lower branches of the
nerve cluster are damaged, those with Erb’s palsy usually retain
movement of their hands and fingers. Erb’s palsy occurs in up to
3 births out of every 1,000.

Risk Factors and Treatment

As mentioned above, nerve damage causes Erb’s palsy. A number of
factors may increase risk of this type of birth injury, one of which is
shoulder dystocia. Shoulder dystocia is an obstructed birth, meaning that
something physically gets in the way of a normal, vaginal birth. In the
case of shoulder dystocia, the anterior (the first to present after the
head) shoulder does not readily follow the head past the mother’s
pubic bone, becoming stuck. Other risk factors include:

  • The use of forceps or vacuum extraction tools during delivery;
  • Infants in a breech position;
  • Large infant size or high birth weight;
  • Small maternal size or excessive maternal weight gain;
  • A long second stage of labor (lasting over an hour).

The injury to the infant and the seriousness of the paralysis is linked
to the kind of damage done to the nerves in the brachial plexus. If the
injury sustained is
neurapraxia, basically a nerve stretching injury that results in a bruise-type injury,
the infant may recover fully on its own without treatment. A
neuroma is a stretching injury where damages to nerves cause scar tissue. In the
case of a neuroma, the infant is likely to recover partially, but not
fully, from the injury.

Ruptures and avulsions are the most serious injuries. A
rupture happens when the nerve itself is torn. An
avulsion occurs when a nerve is torn away from the spinal cord. These kinds of
injuries require surgical treatment, probably to include a nerve graft
or nerve transfer, and intensive daily therapy to minimize the long-term
affect of the injury on the child.


In addition to paralysis or loss of feeling in the arm, a child with Erb’s
palsy will not be able to turn the arm away from the body and will have
limitations in their ability to lift the affected arm up into the air.
Because damage to nerves does affect growth, there will be a more noticeable
difference in the size of a child’s arms as he or she grows into an adult.

If your child is suffering, don’t wait any longer. Shoulder dystocia
and the resulting problems caused by Erb’s Palsy will be life altering
for your child, and the medical expenses can become overwhelming quickly. Call the
shoulder dystocia and Erb’s palsy attorneys at Wagner Reese today, and we will investigate your case to see if your
child’s birth injury could have been caused by negligence on the
part of your attending physician. We offer a completely risk-free, no-cost
consultation: (888) 204-8440.