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Erb-Duchenne palsy or paralysis
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- Erb's palsy is a weakness of the arm that occurs in newborns. It is
caused when the nerves that control the arm are injured during the birth process.
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- Infants with Erb's palsy hold the affected arm at the side, with their forearm
turned inward and their wrist bent. When a baby with Erb's Palsy is stimulated,
the affected arm moves less than the unaffected arm.
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- Erb's palsy is commonly associated with shoulder dystocia. Shoulder dystocia
occurs when an infant's shoulder gets caught and stretched behind the pelvic
bone during delivery.
- The condition can occur, albeit rarely, without being caused by shoulder dystocia.
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- Diagnosis is made clinically.
- If there is a question regarding the reason for the weakness, X-rays can
rule out a fracture.
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- Larger babies are at a higher risk for deliveries that involve damage to their
shoulder, and thus at higher risk for Erb's palsy. For the same reason, mothers
who have a smaller pelvic opening will also have a greater risk for delivering an
infant with Erb's palsy.
- Other risk factors include maternal diabetes, prolonged labor, an infant that
presents in the breech position or induction of labor.
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- Although an affected infant's arm is often placed in a sling for several weeks
to prevent further stretching or rupturing of the affected nerves, specialized
therapy isn't the usual course of action.
- After a period of healing, stretching and range of motion exercises are
prequently performed to help the child recover flexibility.
- Surgical intervention followed by physical therapy may be necessary
when a baby demonstrates no functional recovery by four months of age.
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- 75% to 90% of infants with Erb's palsy will recover completely after several months.
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- Complications include permanent, partial, or total loss of function of the affected
nerves, causing arm weakness or paralysis.
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