Erb’s paralysis

• Erb’s palsy is a paralysis of the arm.
• Also known as Erb-Duchenne palsy

SITE OF INJURY:

• Erb’s point (upper trunk of brachial Plexus) Six nerves meet here(C5 ,C6)

ETIOLOGY:

1. Undue separation of head from shoulder

• Birth Injury [traction of arm]
• Fall on the shoulder/ motor cycle injury
• During Anesthesia

     2. Trauma to the head and shoulder, which cause the nerves of the plexus to violently stretch

NERVE ROOTS INVOLVED:

• Mostly C5 & partly C6

MUSCLES PARALYZED:

• Biceps
• Deltoid
• Brachialis
• Brachio-radialis
• Teres minor
• Partly Supraspinatus, Infraspinatus & Supinator

CLINICAL FINDINGS:

• Arms:  Medially Rotated  (Hangs by side) owing to paralysis of teres minor & infraspinatus.
• Arms: adducted owing to palsy of supraspinatus & deltoid
• Forearms: Extended and Pronated owing to paralysis of biceps brachii, brachioradialis, brachialis
• “Policeman’s tip hand” (or) “Porter’s tip hand”

Loss of movement:

• Abduction & lateral rotation of the arm
• Flexion & Supination of the fore-arm at elbow
• Biceps & Supinator jerks are lost
• Loss of sensations over a small area over the lower part of deltoid

TREATMENT:

The three most common treatments from Erb’s Palsy are:

• Nerve transfers (usually from the opposite leg)
• sub scapularis releases 
• latissimus dorsi tendon transfers.

Don’t Forget to Solve all the previous Year Question asked on Erb’s paralysis