What is Birth-Related Brachial Plexus Injury?
The brachial plexus (BRAY-key-el PLEK-sis) is a network of nerves near the neck that give rise to all the nerves of the arm. These nerves provide movement and feeling to the shoulder, arm, hand, and fingers. Palsy means weakness, and brachial plexus birth palsy causes arm weakness and loss of motion.
With frequent physical therapy exercises, most newborns with brachial plexus birth palsy will regain both mobility and feeling in the affected arm. Parents actively assist their child in regaining the most arm function possible.
These injuries can occur in several ways, including:
- Contact sports. Many football players experience burners or stingers, which can occur when the nerves in the brachial plexus get stretched beyond their limit during collisions with other players.
- Difficult births. …
- Trauma. …
- Tumors and cancer treatments.
Symptoms of Brachial Plexus Birth Injury
Depending on the amount of the injury, the intensity of the symptoms can vary greatly. The damaged arm has limited sensory and motor abilities. Erb’s palsy is the most prevalent (and mildest) form of the condition, characterized by an internally rotated shoulder, an extended elbow, and normal hand and wrist function.
Global palsy, the most severe form of brachial plexus birth damage, manifests as full paralysis of the affected arm, with no function in the shoulder, elbow, forearm, wrist, or hand. Between Erb’s palsy and a worldwide condition, there are intermediate manifestations.
Brachial Plexus Birth Injury Care Options
Initial evaluation of patients with brachial plexus birth injury should take place within the first 1-2 months of life, and it should be performed at a center that specializes in the care of brachial plexus injuries. Even though many cases will recover spontaneously, early therapy with a pediatric occupational/physical therapist is critical to prevent permanent joint deformities from developing. If spontaneous recovery does not occur, surgery may be required to repair or reconstruct the damaged nerves.
In the most severe cases, this type of operation may be considered as early as 3 months of age. As the child grows, surgery may be considered to improve weak muscles and correct joint deformities; usually tendon transfers and bone repositioning.
Brachial Plexus Birth Injury
During delivery of large or smaller babies in breech presentation, the brachial plexus nerves may be stretched and injured. Some risk factors associated with brachial plexus birth injury include long, difficult labor, a larger-than-normal infant, gestational diabetes, maternal obesity, and breech presentation.
Treatment for Peripheral Nerve Injuries
The method used to treat peripheral nerve issues depends on their type. Many wounds, in particular “stretch wounds,” will heal without the need for surgery. Some wounds, particularly serious lacerations or strain injuries, call for surgery to rebuild or repair the damaged nerves.
When it comes to brachial plexus birth injuries, the majority of infants who suffer from this issue will heal completely with just therapy, while others might need intensive therapy and even surgery. Initial treatment entails:
- Specialized occupational treatment to keep the affected arm’s joints mobile and prevent joint deformity.
- It could be necessary to use specialized splints to shield the joints from acquiring abnormalities.
Botulinum toxin, sometimes known as “Botox,” is occasionally used to temporarily weaken “functioning” muscles that are causing joint deformity. Following Botox administration, intense therapy is utilized to help strengthen the “weakened” muscles and realign the shoulder.
If the injury is severe, surgery may be necessary to transfer “redundant” nerves to stimulate muscular activity, repair/reconstruct damaged nerves, or release impacted nerves from surrounding scar tissue.
As kids get older, additional treatments including tendon transfers, joint fusions, or the release of stiff muscles or joints may be advised.
