Clinical Anatomy

Erb's Palsy( Erb-Duchenne Paralysis) : Causes, Deformity, & Treatment

Erb’s Palsy( Erb-Duchenne Paralysis) : Causes, Deformity, & Treatment

Introduction

  • Erb’s palsy or Erb–Duchenne palsy is a paralysis of the arm caused by injury to the upper trunk of the brachial plexus (Erb’s point).
  • Site of injury : The region of the upper trunk of the brachial plexus is called Erb’s point. Six nerves meet here. Injury to the upper trunk causes Erb’s paralysis.
  • Nerve roots involved : Mainly C5 and partly C6.
  • Muscles paralysed : Mainly biceps, deltoid, brachialis and brachioradialis. Partly supraspinatus, infraspinatus and supinator.

Cause

Causes of injury : Undue separation of the head from the shoulder, which is commonly encountered in : (i) birth injury, (ii) fall on the shoulder, and (iii) during anaesthesia.

Menifestation

Deformity (position of the limb) : The deformity is known as ‘policeman’s tip hand’ or ‘porter’s tip hand’.

  • Arm : Hangs by the side; it is adducted and medially rotated.
  • Forearm: Extended and pronated.

Disability : The following movements are lost.

  • Abduction and lateral rotation of the arm (shoulder).
  • Flexion and supination of the forearm.
  • Biceps and supinator jerks are lost.
  • Sensations are lost over a small area over the lower part of the deltoid.

Treatment

The three most common treatments for Erb’s Palsy are : Nerve transfers (usually from the opposite arm or limb), Sub Scapularis releases and Latissimus Dorsi Tendon Transfers.

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