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Brachial Plexus Injuries and Erb’s Palsy

Written by Berkowitz

birth injury attorneyBrachial plexus palsy is a rare birth injury affecting the network of nerves that extends from the neck, throughout the arm, and into the hand. Erb’s palsy, which affects only the upper bundle of nerves, is the most widely experienced type of brachial plexus injury. Erb’s palsies and other types of brachial plexus injuries are typically sustained during prolonged or difficult labor, and approximately two out of every 1,000 infants suffer from one of these conditions. Birth injuries such as Erb’s palsy are often the result of shoulder dystocia which occurs when an infant’s shoulder becomes trapped in the mother’s pelvis during delivery. While most babies recover feeling and movement in the affected arm, total and complete paralysis is possible.



Four Types of Nerve Damage That May Result in a Brachial Plexus Injury:

Neurapraxia: The most benign of brachial plexus injuries, a neurapraxia shocks but does not tear the nerve. This takes place when the nerve is overly stretched during delivery. Neurapraxia usually heals within three months, often on its own.

Neuroma: Neuromas can be more severe than neurapraxia, but are also caused by overstretching. In a neuroma, the nerve was stretched so excessively that permanent scar tissue results. This scar tissue may press on the healthy nerve, causing pain and possible paralysis. Some recovery may occur with time and mild rehabilitative exercises, but full recovery is not common.

Rupture: As the name implies, a rupture is when the stretch injury is so excessive that the nerve is torn (ruptured) from the root. Rupture injuries do not heal on their own and can result in total and permanent paralysis.

Avulsion: The most serious form of brachial plexus injury is avulsion which occurs when the nerve separates from the spinal cord. A small rupture may be repaired with a donor nerve graft, but an avulsion from the spinal cord cannot be repaired.

With careful obstetric management, it is possible to deliver a baby safely when shoulder dystocia is present. To do so, excessive force should be avoided and the obstetric team should utilize careful, controlled procedures to remove the trapped arm or shoulder. Precautions need to be taken before the delivery room, as well, as doctors are often aware of a potential problem before labor begins. For example, prenatal care can identify an unusually large infant, or an unusually small pelvis, both of which may result in shoulder dystocia during labor. Similarly, diabetic mothers are at an increased risk of delivering a large baby which could result in an injury. Each of these situations calls for precautionary measures to be taken before the onset of labor to reduce the risk of shoulder dystocia.

Berkowitz and Hanna LLC – Medical Malpractice and Birth Injury Attorneys

At Berkowitz and Hanna LLC, our team of skilled medical malpractice attorneys knows that negligent medical care can result in serious injury and even death. We understand the emotional complexities surrounding birth injuries, and how financially devastating even minor birth injuries can be. Our compassionate, dedicated legal team will be by your side throughout the entire process, and we can assist you in understanding what you may be entitled to due to medical bills, time away from work, or pain and suffering. Contact Berkowitz and Hanna LLC today for a free consultation about your family’s case.