Brachial plexus birth injuries are a common, yet often preventable injury that can happen during difficult or complicated births. The brachial plexus is a group of nerves located in the shoulder region that control arm and hand function that when damaged in an infant can lead to long-term complications such as Erb’s Palsy. Although some infants recover fully from this type of injury within a few months, others can be left with permanent impairments and disabilities.
Causes Of Birth Brachial Plexus Injuries
A brachial plexus injury during birth is caused by trauma to the infant’s head, neck or shoulder, putting pressure on these delicate nerves. Often this happens when an infant’s shoulder becomes wedged behind their mother’s pelvic bone, resulting in what is called shoulder dystocia. To dislodge the infant, the doctor or midwife may use traction to pull the child, which can cause pressure on the shoulder and damage the brachial plexus.
New techniques used in delivery have reduced the amount of brachial plexus injuries, however they are still all too common. It is estimated that one out every thousand births results in some type of brachial plexus injury. Risk factors include breech delivery, maternal obesity and over-sized newborns. Knowing these risks, many brachial plexus injuries can be prevented by obstetricians through alternative birthing methods or precautions taken during the birth process.
Long-Term Impacts Of Birth Brachial Plexus Injuries
When the brachial plexus is injured during birth, the nerves can be stretched, ruptured or even be torn from the spine. Depending on the extent of the damage, the child may recover without any long-lasting effects or have some degree of paralysis injury. Those with damage can have a form of palsy such as:
- Erb’s Palsy. In Erb’s Palsy usually the nerves controlling the upper arm and shoulder are damaged. This can result in loss of full movement of the arm and difficulty gripping objects.
- Klumpkes Palsy. Although rare, in some cases only the nerves controlling the hand and wrist are affected, which is called Klumpkes Palsy. This can cause weakness in the wrist and loss of control of some of the small muscles in the hand.
- Complete Brachial Plexus Palsy. The most severe type of palsy caused by a brachial plexus birth injury is when all five nerves are damaged. This can cause paralysis of the arm from the shoulder down.
In most infants, if the brachial plexus birth injury is not repaired by the time they are two years of age, the results will be permanent. Surgical options and therapy can be used, however if the nerves are too greatly damaged the child will most likely have some loss of sensation or movement in the affected arm or hand. What happens in just a few minutes during their birth can impact these children for the rest of lives, having life-changing consequences. The heartbreak is that many of these injuries could have been prevented and cause needless pain and long-term disability on other wise healthy newborns.