Permanent Erb palsy: A traction-related injury?

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 89; no. 1; pp. 139 - 141
• Main Authors: Ouzounian, Joseph G., Korst, Lisa M., Phelan, Jeffrey P.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 1997; The American College of Obstetricians and Gynecologists; Elsevier Science
• Subjects: Biological and medical sciences; Delivery. Postpartum. Lactation; Disorders; Dystocia; Female; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Medical sciences; Paralysis, Obstetric - etiology; Pregnancy; Traction; Human; Nervous system diseases; Pregnancy disorders; Motor system disorder; Spasticity; Muscle tonus alteration; Case study; Striated muscle disease; Newborn diseases; Paraplegia; Newborn; Delivery disorders; Complication; Obstructed labor; Peripheral nerve disease; Neurological disorder; Brachialis plexus syndrome
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1016/S0029-7844(96)00312-2

Historically, the primary risk factor attributed to brachial plexus injury during birth has been excessive traction applied at delivery to an entrapped anterior shoulder. However, recent evidence has suggested that not all cases of brachial plexus palsy are attributable to traction. We have encountered several cases of permanent Erb palsy associated with birth that were not attributable to traction applied at delivery. We reviewed cases of neonates with documented permanent Erb palsy that occurred either in the absence of shoulder dystocia or in the neonate's posterior arm in the presence of anterior shoulder dystocia. We identified four cases that occurred in the absence of shoulder dystocia and four cases that occurred in the posterior arm of infants with anterior shoulder dystocia. These data further support the notion that the etiology of permanent brachial plexus palsy associated with birth may not be related to traction.