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ERB’S PALSY, KLUMPKE’S PARALYSIS - Coggle Diagram
ERB’S PALSY
Effects of the Injury
At the shoulder
- here, there is paralysis of the deltoid, rhomboids,
supra- and infraspinatus and teres minor muscles.
- This results in the loss of shoulder abduction and external rotation
At the elbow
- biceps and brachialis muscles are paralyzed.
- This results in loss of flexion of the elbow joint.
At the forearm
- Supinator, muscles are paralyzed resulting in loss of supination of the forearm
The combined effect of the injury is
- an arm hanging loosely by the side of the trunk.
- The shoulder is internally rotated,
- the elbow is in extension,
- the forearm is pronated and
- the wrist is in flexion.
This characteristic posture is popularly known as Policeman or Waiter’s tip.
Apart from this, there may be sensory loss on the outer aspects of the arm and forearm both in the front and back.
Management
- This is done by using an abduction or aeroplane
splint.
- The shoulder is maintained in abduction and
external rotation, elbow in 90° of flexion, forearm
in supination and wrist in extension.
- Measures to Prevent
Contractures
-
This is rarely indicated as most of the cases recover spontaneously with the above treatment.
.
- Exploration and repair of the nerve roots.
- Tendon transfers to improve abduction and external rotation of the shoulder.
- Release of soft tissue contractures.
- De-rotation osteotomy for the rotational deformity.
- This is due to injury to the C5 nerve root and rarely the C6 nerve root is injured.
.
- It occurs either very early in life due to
birth trauma (obstetric palsy, due to faulty application of forceps)
- or in young adults due t.o bike trauma
-