|
|
Brachial Plexus & Erb's Palsy Attorneys
 |
History of Erb's PalsyA midwife first described brachial plexus injuries in 1779 by the paralysis of the arms muscles due to injury of its nerves in the neck. Described was a series of infants with injury to the upper part of their plexus telling of the characteristic posture of the hand, first called the policeman’s tip and then the porter’s tip. These terms were referring to the arm extended at the side and internally rotated at the shoulder so that the palm projects outward and flexion at the wrist. Erb was first reported around the same time that brachial plexus injuries were being noted and Erb and Duchenne have been associated to this particular form of brachial plexus palsy as it is referred to as Erb’s-Duchenne’s palsy. Later on someone by the name of Klumpke described the clinical picture of injury to the lower plexus. It was observed to cause paralysis of the hand’s muscles and as associated dilation of the eye’s pupil on the side of the injury. Klumpke’s name was associated to this particular form of brachial plexus palsy when observed in infants and continues to be called Klumpke’s palsy. Duchenne recommended in the 1870’s treating Erb’s palsy with electrical stimulation of the paralyzed muscles. The Erb’s palsy treatment was very uncomfortable to the child and did not become a favorable form of treatment. Different forms of splinted positions were then recommended as to avoid the secondary complications due to progressive muscle contracture. Other forms of Erb’s palsy treatments were tried with varying degrees of success to help the arm deformity associated to brachial plexus, including tendonotomies, cutting of contracted muscle tendons to gain additional movement blocked by the contracted muscle, capsulotomies, cutting of capsule of a frozen joint, and rotational osteotomies, cutting through the bone of the upper arm and rotating it into a better positioning and fixating it with a plate. In 1903 a man by the name of Kennedy was the first to describe surgical exploration of 3 infant’s necks that had sustained injury to the brachial plexus. Kennedy found injured C5 and C6 roots in all of the babies and resected the zone of injury to the nerves and sewed the cut ends back together. Kennedy found the surgical brachial plexus exploration to be encouraging. Clark followed up with a report in 1905 that found similar findings as well as a 29% mortality rate associated with the brachial plexus surgery. Later, in 1920, a group of 70 infants endured the brachial plexus surgery with only one death resulting from the surgery. The surgery on the brachial plexus appeared to be a break through until 1922 when Bentzon advised against surgery because he found the outlook for the infants untreated to be good and the published outcomes of the infants who had been through brachial plexus surgery as unimpressive. Sever released a review in 1925 of 1,100 infants that he had treated and concluded that many of the infants who had brachial plexus surgery had very little gain. Sever felt that physiotherapy and bracing were more beneficial than the brachial plexus surgery. Then in 1930 Lauwers concluded that the morbidity and mortality that was associated to the brachial plexus surgery was excessive and should be avoided. After all these conclusions from various people, brachial plexus surgery was abandoned. A report in 1980 by Gilbert brought up brachial plexus surgery once again. In the mid-1980’s Gilbert’s group was supporting the surgical exploration of any infant that showed no brachial plexus movement at three months after birth. Every case that he saw he found the injury requiring excision of injured nerve tissue and grafting. When he analyzed his results of 178 children two years following brachial plexus surgery, he found that the children experienced one grade higher of improvement than compared to a non-brachial plexus surgery child on average. Since then many different groups have had positive regard for brachial plexus surgery and it is still being performed on Erb’s palsy injuries today. For more information on Erbs Palsy contact us to confer with an Erbs Palsy lawyer. The Center for Brachial Plexus Palsy and Erbs Palsy Information represents attorneys throughout the United States providing information and legal advice for victims. Alabama • Alaska • Arizona • Arkansas • California • Colorado • Connecticut • Delaware • D.C. • Florida • Georgia • Hawaii • Idaho • Illinois • Indiana • Iowa • Kansas • Kentucky • Louisiana • Maine • Maryland • Massachusetts • Michigan • Minnesota • Mississippi • Missouri • Montana • Nebraska • Nevada • New Hampshire • New Jersey • New Mexico • New York • North Carolina • North Dakota • Ohio • Oklahoma • Oregon • Pennsylvania • Puerto Rico • Rhode Island • South Carolina • South Dakota • Tennessee • Texas • Utah • Vermont • Virginia • Washington • West Virginia • Wisconsin • Wyoming Other Helpful Resources:
|
| Home | Contact a brachial plexus palsy erbs palsy lawyer | Site Map | |
