Have you ever noticed someone being tipped by a waiter and wondered what could have caused it? While this particular physical characteristic in humans may appear to be a genetic mutation or a disease, in reality this physical deficiency is a birth injury. Server hand tipping is just one form of Erb’s palsy, an injury to the nerves in the brachial plexus. As a result of this injury, the affected arm may become disabled or paralyzed. Most often, Erb’s palsy causes only moderate disability of the arms, but in severe cases it can lead to complete paralysis of the body below the shoulder.
Causes of Erb’s Palsy
Erb’s palsy is caused by injury to the brachial plexus, which is basically a group of nerves in the shoulder connecting the arms and the neck. It can sometimes be confused with other lesions of the brachial plexus; however, what distinguishes these different wounds is the melting point in the group where the wound is caused. Damage to the two upper brachial nerves, C5 and C6, causes Erb’s palsy. Brachial plexus nerves carry nerve impulses from the brain to muscles in the arms, hands, and fingers that allow movement and locomotion. Erb’s palsy, however, does not limit the movement of the hands and fingers, but only the affected arm is impaired.
Characteristics of Erb’s Palsy
The most prominent feature of Erb’s palsy is the physical impairment of the arm. This disability impairs feeling and feeling in the affected arm and causes immobility which can be partial or complete paralysis of the body from the neck down. All of these factors lead to muscle atrophy. “In some cases, although the disability is not so obvious, in most cases, especially severe cases, the impairment is much more visible and can be perceived as abnormal. The arm is not attached properly and appears to be suspended. The wrist goes outward, sometimes called the server’s tip,” says attorney Russell J Berkowitz of Berkowitz and Hanna LLC Malpractice & Injury Lawyers.
Categories and treatment
There are generally four categories of Erb’s palsy namely neuropraxia, neuroma, rupture and avulsions, all of which are treated differently and also have different treatment outcomes. The first, Nueropraxia, is the mildest form of Erb’s palsy and results from a minor shock to the nerves instead of a tear. It usually heals within three months of birth and doesn’t require much treatment. A neuroma results from severe stretching and often results in extreme burning sensations in the arm. It can heal sometimes but not completely and takes several years. Surgery and physiotherapy are possible treatments. The rupture is caused by torn nerves that may need to be transplanted by a surgeon from another part of the body to return to normal, and this condition cannot heal without surgery. On the other hand, avulsion occurs when the nerves detach from the spinal cord, which completely restricts the movements of the arm. Almost no recovery is possible even after the surgery.
Since Erb’s palsy is a form of birth injury caused by the tearing of nerves during vaginal delivery, surgeons should be careful and take preventative measures to reduce the risk.