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Erb’s Palsy: A Common Injury Sustained During Birth

by | Jan 13, 2017 | Uncategorized

The birth of a child is supposed to be one of the happiest moments in the lives of the parents; however, sometimes birth injuries result that can turn a moment of joy into a moment of sadness. While some defects, such as congenital defects, might unavoidable, other injuries are the result of avoidable circumstances that occur during birth.

One of the injuries is called Erb’s Palsy and can create a lifelong disability for the child. It is important for parents to understand Erb’s Palsy and the mechanism of injury. By understanding the condition and how it is caused, parents can better advocate on behalf of their children with the assistance of an experienced attorney. 

What is Erb’s Palsy?

Erb’s Palsy is one of the brachial plexus injuries that can result during birth. The brachial plexus is a group of nerves that powers the arm. If these nerves are severed, the patient could lose mechanical function or sensation to certain areas of the arm. In Erb’s Palsy, the C5 and C6 nerves are severed in the upper arm. Loss of these nerves severs the power to the deltoid muscles, biceps, and brachialis muscles on the affected side. Patients who loose these muscles will rotate their arm inward. The forearm will be extended and pronated. Doctors have described this presentation as “waiter’s tip” because the patient looks like a waiter trying to ask for a tip.

How does this happen?

The most common mechanism that leads to the development of Erb’s Palsy is through a birth complication known as a shoulder dystocia. Sometimes, the baby doesn’t fit through the birth canal. One of the common reasons why is that the shoulder is bumping against the pelvis of the mother and is unable to fit through, called a shoulder dystocia. If the baby is forced through the birth canal, bones in the shoulder and clavicle might be fractured. The pieces of this fracture could sever the nerves and create an Erb’s Palsy.

How is an Erb’s Palsy Diagnosed?

An Erb’s Palsy is often diagnosed with its stereotypical clinical presentation because the presentation is classic; however, imaging is sometimes done to confirm the presence of fractures and locate bone fragments that might have damaged the nerves. These images are also important for planning the surgery and deciding what kind of intervention is appropriate.

What should be done if the patient has an Erb’s Palsy?

While some children will recover on their own with time, many cases require the treatment of a specialist. A surgeon might be needed to repair the fracture and physical therapy is required to restore muscle use. While many children will make some form of a recovery, individuals with complete tears will rarely regain the full function of their arm. Those that make a recovery will often have some form of arthritis at an earlier age than their peers.

Anyone with concerns regarding birth injuries, such as an Erb’s Palsy, should contact an experienced attorney for assistance.


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