Acta Scientific Orthopaedics (ISSN: 2581-8635)

Case Study Volume 5 Issue 4

Effect of Early Intervention in an Infant with Erb’s Palsy

Mythili Kasthurirengan*

Department of Pediatric Rehabilitation, RECOUP Neuromusculoskeletal Rehabilitation Center, India

*Corresponding Author: Mythili Kasthurirengan, Department of Pediatric Rehabilitation, RECOUP Neuromusculoskeletal Rehabilitation Center, India.

Received: February 18, 2022; Published: March 04, 2022

Abstract

Erb’s palsy is a type of weakness or paralysis of muscles of upper limb due to traction injury to brachial plexus mostly during birth. Severity of symptom is based on level of injury. It is also sometimes called brachial plexus palsy. The mode of injury is mostly traction of head and neck at the side when the shoulders are passing through the birth canal during labor in head first delivery. But can also occur due to forceps delivery injury or vacuum extraction injury, breech presentation or when pulling the arm forcefully after birth. In case of mild and moderate level injury this condition improves in time, but some kids can have permanent complications if left untreated. Here an infant with of Erb’s palsy during birth and effect of early intervention on that infant is presented. The location of injury is the point where C5 and C6 form the upper trunk which is also known as Erb’s point. The nerves affected are, supra scapular nerve (C5, 6), axillary nerve (C5, 6) and musculocutaneous nerve (C5, 6, 7). Muscles affected are from proximal supraspinatus, infraspinatus, serratus anterior, deltoid, biceps and brachialis. Thus this condition affects shoulder external rotation, abduction flexion and elbow flexion and supination. Due to opposite muscle pulling the arm will end up in adduction, internal rotation elbow extension and forearm pronation. This position is classically known as waiters tip position or policeman tip hand. It is important to understand the anatomy for diagnosis and proper management. With proper intervention many children can attain normal or near normal functions by 6 to 7 months of age but the injury can take up to 2 years to recover fully.

Keywords: Erb’s Palsy; Erb’s Point; Upper Trunk; Waiters Tip Position; Early Intervention

References

  1. Erb WS. “Ueber Eine Eigent humliche Localisation Von Lahmengenim Plexus Brachialis”. Verhandl D Naturhist Med. 2 (1874): 130-137.
  2. Bannister LH., et al. “Gray’s Anatomy, anatomical basis of anatomy and surgery”. 38th London: Churchill Livingstone (1999): 1266-1267.
  3. Tortora GJ and Anagnostakos NP. “Principles of Anatomy and Physiology”. 6th New York: Harper and Row; (1990): 370-374.
  4. Allen RH and Gurewitsch ED. “Temporary Erb-Duchenne palsy without shoulder dystocia or traction to the fetal head”. Obstetrics and Gynecology 5 Pt 2 (2005): 1210-1212.
  5. Christoffersson M., et al. “Shoulder dystocia and brachial plexus injury: a case-control study”. Acta Obstetricia et Gynecologica Scandinavica 2 (2003): 147-151.
  6. Gherman RB., et al. “Spontaneous vaginal delivery: a risk factor for Erb’’s palsy?” American Journal of Obstetrics and Gynecology 3 (1998): 423-427.
  7. Weizsaecker K., et al. “Labour characteristics and neonatal Erb’s palsy”. BJOG An International Journal of Obstetrics and Gynaecology 8 (2007): 1003-1009.
  8. Eng GD., et al. “Obstetrical brachial plexus palsy (OBPP) outcome with conservative management”. Muscle Nerve 7 (1996): 884-891.
  9. Peleg D., et al. “Fractured clavicle and Erb’s palsy unrelated to birth trauma”. American Journal of Obstetrics and Gynecology 5 (1997): 1038-1040.
  10. “Clinicians guide to active movement scale”. www.regionvasterbotten.se
  11. https://www.physio-pedia.com/Erb%27s_Palsy

Citation

Citation: Mythili Kasthurirengan. “Effect of Early Intervention in an Infant with Erb’s Palsy".Acta Scientific Orthopaedics 5.4 (2022): 49-52.

Copyright

Copyright: © 2022 Mythili Kasthurirengan. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days

Indexed In



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is November 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US