Brachial plexus injury patterns

Erb's palsy

Mechanism

increase in angle between neck and shoulder - classically difficult birth

clinical presentation

weakness/loss of:

  • abduction
  • lateral rotation
  • flexion

therefore, 'waiter's tip deformity' is described as:

  • arm held in medial rotation and extention

Klumpke's palsy

mechanism

arrest of a fall by grabbing on to a projection, or motor vehicle accidents
may be accompanied by damage to sympathetic fibres → Horner's syndrome

pathogenesis

functionally injury to ulnar and median nerves
C8-T1

clinical presentation

clawed hand -
paralysis of lumbricals = hand becomes extended at the MCPJs and flexed at the IPJs