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