The brachial plexus refers to the constellation of five nerve groups which proceed from the spinal cord in the neck to the shoulders, arms, wrists and fingers.
The stretching or tearing of the nerves in the brachial plexus by the careless practitioner during the course of vaginal delivery can cause the partial or total paralysis of the muscles in either the left or right shoulder, arm, or hand.
Nerve injuries involving the stretching or tearing of the nerves leading from cervical vertebrae #7 and #8 (C7-8) and thoracic vertebra #1 (T/1) results in a condition known as Klumpke’s Palsy.
Nerve injuries involving the stretching or tearing of the nerves leading from cervical vertebrae #5 or #6 (C5-6) results in a condition known as Erb’s Palsy.
Severe brachial plexus injuries almost always occur during the course of the vaginal delivery of the baby, when the unsafe and careless practitioner applies excessive force to the baby’s head and neck during the process of delivery. Such pulling and twisting of the baby’s head and neck will stretch and sometimes tear the nerves comprising the brachial plexus.
An unsafe and careless medical practitioner may pull or twist the baby’s head and neck if the baby’s shoulder becomes “stuck” behind the mother’s pubic bone in the birth canal. This condition is typically known as a “shoulder dystocia.”
Although the medical community has developed maneuvers that will permit a baby to be safely delivered even if a shoulder dystocia occurs, many unsafe and careless practitioners do not understand or fail to properly apply these maneuvers, thereby directly causing a brachial plexus injury.
Brachial plexus injuries often result in the rupture or tearing of the nerve roots, sometimes called an avulsion. Severe brachial plexus injuries involving the rupture or tearing of the nerve roots do not typically resolve on their own, even with interventions such as physical therapy and stretching and range of motion exercises. Often, the definitive treatment for severe brachial plexus injuries involving the rupture or tearing of the nerve roots is surgery, which may include nerve reconstruction surgery or muscle-tendon replacement surgery.
A permanent brachial plexus injury may leave the child with a deformed and paralyzed arm and hand. Children with a brachial plexus injury resulting in Klumpke’s Palsy often are unable to manipulate the fingers on the affected hand, which may remain a “claw.”
A permanent brachial plexus injury can affect a child’s self-esteem, and severely limit his or her ability to perform daily tasks such as getting dressed, bathing, and tying shoes. Moreover, when the child becomes an adult, a severe brachial plexus injury can restrict employment opportunities, especially in occupations requiring bimanual skills or the use of two strong, functioning arms.