Erb's paralysis

INTRODUCTION:
  • 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:
  1. Abduction & lateral rotation of the arm
  2. Flexion & Supination of the fore-arm at elbow
  3. Biceps & Supinator jerks are lost
  4. 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.
Exam Question
  • Erb's point (upper trunk of brachial Plexus) Six nerves meet here(C5 ,C6)
  • Nerve roots involved in erb's palsy are Mostly C5 & partly C6
  • Arms: Medially Rotated (Hangs by side) owing to paralysis of teres minor & infraspinatus.
  • Policeman's tip hand (or) Porter's tip hand seen in erb's palsy
  • Abduction & lateral rotation of the arm
  • Flexion & Supination of the fore-arm at elbow

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