Erb’s palsy is a condition involving injury to the brachial plexus, a network of five large nerves that send messages from the spine to control movement and feeling in the shoulder, arm and hand.
Injuries to the brachial plexus involve tearing or stretching of the nerves or pressure on the nerve caused by scar tissue where an injured nerve has tried to heal.
The injury results in full or partial paralysis, or weakness, of one or both arms, reducing muscle function and the ability to grasp, extend or reach with the affected limb. It can also cause muscular and skeletal deformities and shortened limbs.
Most brachial plexus injuries occur during childbirth. Most often, the arm and shoulder has been forced down with the head and neck stretched sideways in the other direction. Usually but not always, shoulder dystocia is the cause- the baby’s shoulder gets stuck against the mother’s pubic bone which is then an emergency situation.
Diagnosis of brachial plexus injuries needs careful neurological examination by a specialist to determine which nerves have been injured and to what extent.
Treatment depends on the type and severity of the injury. Nerves that have only been stretched may recover without further treatment other than physiotherapy to prevent joint stiffness and muscle contractures but in other cases, surgery may be indicated.
A claim for compensation will only succeed if it can be proven that the injury was avoidable. Typical breaches of duty include:
- Failure to estimate a large baby’s size and weight prior to delivery
- Failure to recognise and treat maternal diabetes which is a risk factor for having a large baby
- Failure to carry out appropriate manoeuvres or use the correct tools if the baby is stuck in the birth canal
- Application of unnecessary and excessive force during delivery
- Failure to carry out a caesarean section where it is clinically indicated
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