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Erb's Palsy / Erb Duchenne Palsy
Definition: Erb's palsy / Erb Duchenne Palsy is a paralysis of the arm resulting form damage of the upper fibres of the brachial plexus (roots C5-C7).
Causes: Erb's palsy/ Erb Duchenne Palsy is usually the result of dystocia. Erb's palsy can also manifest itself in neonates affected by a clavicle fracture unrelated to dystocia. Other causes inlcude traumatic injuries to the lateral aspect of the cervical spine, such as falls onto the side of the head and shoulder leading to a traction or compression palsy (depending on the vectors). Innacurate glenohumeral dislocation reductions can also lead to an iatrogenic Erb's Palsy. Gun shot and stab wounds are also associated with this condition.
Examination: Erb's palsy is a lower motor neurone condition with the associated characteristics of such a pathology. Upon observation, the examiner should look out for muscular atrophy, fasciculations, hypotonia, asthenia, and hypo or areflexia.
The presentation and distribution of the aforementioned signs will vary in accordance with the affected nerve roots. For example: damage to the C5 nerve root will affect that respective dermatome and myotome.
A common sign of Erb's palsy is the characteristic waiter's tip posture, resulting from the loss of innervation of the deltoid, biceps brachii, teres minor, brachialis and brachioradialis, with the occasional involvement of the supraspinatus, infraspinatus and supinator muscles.