BRACHIAL PLEXUS INJURIES
brachial plexus injury (Erb's Palsy) is a nerve injury. The nerves
that are damaged control muscles in the shoulder, arm, or hand.
Any or all of these muscles may be paralyzed. Children with brachial
plexus injuries are affected in different ways. Here are some examples:
children have no muscle control and no feeling in the arm or hand.
children can move their arms, but have little control over the
wrist and hand
children can use their hands well but cannot use the shoulder
or elbow muscles.
child's disability depends on which nerves are injured and how severely
they have been damaged.
is the Brachial Plexus?
brachial plexus is a network of nerves. It conducts signals from
the spine to the arm and hand. These signals cause the arm and hand
muscles to move. (Brachial means arm, and plexus refers to a network
Causes Brachial Plexus Injuries?
injury can occur at any time, most brachial plexus injuries happen
during birth. Many babies with brachial plexus injuries are larger
than average at birth. However, newborns of all sizes, including
premature babies, can have these injuries. About 1 or 2 babies in
1,000 suffer brachial plexus injuries at birth. About 1 in 10 of
these need treatment. The possible treatments are exercise and therapy,
or surgery plus therapy.
are four types of nerve injuries:
avulsion: the nerve is torn from the spine.
rupture: the nerve is torn but not where it attaches to the spine.
neuroma: the nerve has tried to heal itself, but scar tissue has
grown around the injury. The scar tissue puts pressure on the
injured nerve. As a result, the nerve cannot conduct signals to
the nerve has been damaged but not torn. These injuries heal on
their own. If your child has praxis, you should see improvement
within 3 months.
or more of the nerves in the brachial plexus may be injured. The
nerves may have the same or different kinds of injuries. Because
the injuries cause the same symptoms, it is difficult to know what
kind of injury has occurred.
for Brachial Plexus Injuries
may help children who do not recover by the age of 5 months. Nerve
surgery is done by a pediatric neurosurgeon. The purpose of surgery
is to improve how well the arm functions. Nerve surgery is most
effective when it is done between the ages of 5 and 12 months. After
children turn 1 year old, the surgery may not be as successful.
some children, neurosurgery is not recommended or is not successful.
In these instances, other procedures can be done to transfer muscles
and tendons. This surgery is done by a plastic surgeon when the
child is older.
for Brachial Plexus Injuries
recommend daily exercises that help to keep the muscles and joints
moving normally. They are called range of motion exercises. If your
child is not able to use muscles in the arm and hand, these muscles
will stay weak. The arm may not grow normally, and you may feel
tightness in some muscles and joints. A joint that stays in the
same position all the time can actually "freeze". Exercises
keep the muscles and joints flexible. When the nerves start working
better, the muscles and joints will be ready to work. An occupational
or physical therapist will work with your child. The therapist will
also help you (the parent) learn to do the exercises. Most parents
need to do the range of motion exercises at home with their children
two to three times a day for several years.
with permission from
United Brachial Plexus
1610 Kent St.
Kent, OH 44240