What Do Parents Need to Understand About Brachial Plexus Injuries?

Although doctors in Montana may downplay the significance of brachial plexus injuries that occur during childbirth, parents need to understand the potential long-term effects and how to help their child achieve the best quality of life going forward. It is important to take certain actions as soon as possible to preserve legal rights and physical recovery.

Knowledge is one of your best tools when you learn that your child is suffering from a birth injury. In this post, we explain what the brachial plexus is and how injuries can affect your child’s body. If the injuries could have been prevented, you may be able to recover compensation to help meet the child’s needs for the future and to offset the intangible effects of the injury. So we also discuss the potential to recover compensation for birth injuries and how to determine whether medical malpractice was responsible for the harm to your child.

What is a Brachial Plexus Injury?

A brachial plexus injury occurs when nerves in the brachial plexus network are damaged in some way. Injuries range from mild to severe. Some brachial plexus injuries can be treated and healed, while others lead to permanent injury and disability.

Where are the Brachial Plexus Nerves?

The brachial plexus nerve network runs throughout the shoulder area, starting in the neck and continuing through the arm. Nerve roots begin in the cervical and upper torso sections of the spinal cord from the C5 to T1 vertebrae. The brachial plexus nerves connect the spinal cord to the nerves throughout the hands and fingers.

The complex anatomy of this nerve network is divided into trunks, divisions, cords, and branches. There are five major branches that extend down the arm:

• The axillary nerve originates in roots near cervical (neck) vertebrae C5 and C6
• The median nerve stems from the spinal cord between the C6 through T1vertebrae
• The musculocutaneous nerve has roots near the C5, C6, and C7 vertebrae in the neck
• The radial nerve starts in the region between the C5 and T1 vertebrae
• The ulnar nerve originates lower in the C8 through T1 vertebrae

Each of these branches extends from the roots in the spinal cord through three main trunks that split into divisions and branches that extend throughout the arm and down through the fingers.

What Functions Do the Brachial Plexus Nerves Fulfill?

Together, the brachial plexus nerves control virtually all movements of the shoulder, arm, wrist, and hand, as well as transmitting sensation from these areas. The axillary nerve controls movement of the shoulder, including enabling it to raise and rotate the arm and lift it away from the body. Moving downward, the radial nerve controls the triceps and some forearm muscles to straighten the elbow, wrist, and fingers. 

The musculocutaneous nerve controls the biceps muscles to enable the elbow to bend and palms to turn up. Most of the forearm flexors are powered by the median nerve, which allows the wrist and fingers to bend and the thumb to turn inward. Finally, the ulnar nerve controls intricate movements of the hands and fingers.

In addition to controlling movement, these nerves fulfill sensory functions throughout the shoulder, arm, and hands. Loss of function in any of these nerves can have a profound impact on gross and fine motor skills.

What Happens When a Brachial Plexus Nerve is Injured?

Delicate nerve tissue can be damaged in several ways. Many brachial plexus injuries occur when nerves are:

• Stretched beyond capacity
• Compressed
• Torn
• Pulled away from the spinal cord (avulsion)

Sometimes the damage can be repaired through surgery, and sometimes the nerves may heal at least partially on their own. But damage may be permanent and lead to lifelong impairment.

How Do Brachial Plexus Injuries Occur During Childbirth?

When certain complications occur during labor, doctors use different techniques to overcome the problems, and these techniques can damage brachial plexus nerves, particularly when they are performed with excessive force. Sometimes, brachial plexus injuries cannot be avoided to prevent other injuries to the baby or mother. But far too often, preventable errors cause brachial plexus injuries.

Many times, doctors in Montana do not pay close enough attention to recognize potential complications during delivery, and then they need to act in haste. They should be aware and make proper preparations for a breech presentation or macrosomia, but often fail to do so. Sometimes action becomes necessary because delivery is prolonged or because the baby’s shoulder gets stuck behind the mother’s pubic bone. During these situations, doctors may use excessive traction on a baby’s head or neck. Or they may improperly maneuver the baby’s body.

When a brachial plexus injury results from lack of proper prenatal assessment or inappropriate delivery techniques, then it could be considered actionable malpractice.

What are the Signs of Brachial Plexus Injuries? What Symptoms Should Parents Watch For?

Parents who observe the following symptoms should have their child examined for potential brachial plexus injuries:

• Weakness in one arm
• One arm hanging limp
• Limited movement ability in a shoulder
• One arm is consistently rotated inward
• Reduced grip strength on one side

Soon after birth, doctors frequently check babies for the Moro reflex. When triggered by a bright light or loud noise, the startled baby suddenly stretches out their arms and legs, flings their head back, and then pulls everything in tight with a hugging motion. Babies tend to exhibit this reflex until they reach about four to six months of age. If a baby only exhibits signs of the reflex on one side of the body, that can be an indication of a brachial plexus injury or other nerve damage.

What is Erb’s Palsy?

Erb’s palsy is a common brachial plexus injury that usually impacts the upper nerves in the brachial plexus network. It manifests as difficulty lifting the arm, limited shoulder movement, generalized arm weakness, and a tendency to keep the elbow bent. 

The reduced range of motion, weakness, and loss of sensation often become permanent disabilities. Prompt treatment can sometimes reduce the impact of Erb’s palsy, but the child may never have full functional use of the arm, impacting the ability to perform daily activities and limiting the ability to enjoy many hobbies or practice certain professions.

How are Brachial Plexus Injuries Diagnosed and Treated?

Doctors generally need to conduct both a physical examination and neurological assessment to properly determine whether symptoms are caused by a brachial plexus injury. They may use diagnostic tools such as:

• Ultrasound
• MRI
• Electromyography
• Nerve conduction studies

The earlier the condition is diagnosed, the more treatment options are available, so early intervention can be quite beneficial. Surgery may involve nerve grafting, nerve transfers, or tendon transfers. This is supplemented by physical and occupational therapy, including stretching exercises. Regular monitoring of the condition and progress is critical.

FAQs About Brachial Plexus Injuries

What long-term effects can result from brachial plexus injuries?

Erb’s palsy and other brachial plexus injuries generally limit functioning in the arm, shoulder, or hands, and this can lead to muscle atrophy, joint stiffness, and chronic pain. Parts of the arm or hand may suffer permanent weakness or paralysis. Children with brachial plexus injuries tend to fall behind many developmental milestones and suffer mental anguish due to limitations and the burden of continual surgery, treatments, and therapy.

When is a brachial plexus injury caused by medical malpractice?

While not every brachial plexus injury results from medical malpractice, there are many situations in which injuries could have been prevented if a medical professional had acted in accordance with reasonable standards of care. Some of the most common medical mistakes that lead to brachial plexus injuries include:

• Failing to identify high-risk factors during pregnancy
• Failing to develop an appropriate treatment plan for a high-risk pregnancy
• Not recommending a cesarean delivery when necessary
• Use of improper methods or techniques with shoulder dystocia
• Delays in responding to fetal distress that create unnecessary urgency
• Excessive traction during delivery

How do I know when I need to talk to a birth injury attorney?

It costs you nothing to consult a birth injury attorney at Ragain & Clark, so if you have concerns about how the injuries occurred or you believe the injuries may lead to long-term impairment, then you should learn about the potential for recovery. The medical expenses, need for long-term treatment, and effect of disability are all factors that put a drain on the entire family, and compensation from a personal injury lawsuit can provide resources to offset these burdens and provide for the child’s future needs.

Ragain & Clark Understands How to Hold Medical Professionals Accountable When Their Mistakes Cause Injuries

It is hard to watch a child fall behind because of medical mistakes that could have been prevented. While the team at Ragain & Clark cannot magically heal Erb’s palsy and other birth injuries, we are often able to obtain justice that goes a long way toward healing. The compensation we recover provides resources to address many of the additional needs resulting from brachial plexus injuries. To find out more about what may be possible in your case, contact us online or call us at 406-651-8888 to schedule a free consultation.