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clair hemming

Posted 23 October 2018
by Clair Hemming

Erb’s Palsy Group Awareness Week

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We are proud to support the Erb’s Palsy Group in raising awareness of the condition of Erb’s Palsy this week.

Erb’s Palsy (sometimes known as brachial plexus palsy) is caused by injury to the brachial plexus. The brachial plexusis a network of nerves that conducts signals from the spinal cord to the shoulder, arm and hand. These nerves originate in the fifth, sixth, seventh and eighth cervical (C5-C8), and first thoracic (T1) spinal nerves, and innervate the muscles of the chest, shoulder, arm and hand.

Erb’s Palsy can vary in severity depending upon the degree of damage and number of nerves affected.   Typically, the upper limb has a reduced range of movement at the shoulder, elbow and forearm with reduced power and strength.   More serious injuries will affect sensation and hand function.  When the injury occurs at birth, the development of the limb as the child grows is significantly affected due to abnormal innervation (nerve supply).  The limb will typically grow to be shorter and smaller, there will abnormal joint development and there will secondary problems due to muscle imbalance.  The limb, cosmetically will look very different to the unaffected side.  Whilst surgery is available to improve matters by repairing the initial damage and managing secondary problems, full function cannot be restored.

Injury to the brachial plexus commonly happens during birth, but these injuries are rare.  The standard rate of permanent injury is approximately 0.43 per 1,000 vaginal births.   Unfortunately, therefore many professionals will not have experienced the condition before and may not be best equipped to treat it.

To raise awareness of this condition and to support the Erb’s Palsy Group we are running a series of articles this week.  We have almost 25 years of experience in assessing the impact and effects of this condition in order to secure compensation for children and young adults in clinical negligence claims.  We have developed a wealth of knowledge in relation to this condition.

Rather than focusing on the physical impact of this injury however, in this series of articles we will be concentrating on the psychological effects which can in some circumstances, be equally or more debilitating than the disability itself.

The more severe injuries are cosmetically obvious but even when it is not, the abnormal or restricted movement is noticeable.  When they reach adolescence children naturally become more self-conscious and aware of their body image. They do not want to stand out by looking different   Being unable to do normal things that their peers can such as fully participate in lessons like PE or Science or even just eating their lunch, sets them apart.  They will have to deal with disruption to lessons and have to explain absences from school due to medical appointments, which will reinforce these feelings. Many experience teasing or bullying.  Secondary school can be a very difficult and demanding time and given how rare this condition is many find that teachers are not as understanding as they could be simply through ignorance

We find that it is not uncommon for children with Erb’s Palsy, to go through a difficult time during adolescence, yet until that point they have seemed well adjusted to their disability.  Some will suffer low self-esteem, and lack confidence affecting their social interaction and can become isolated, and depressed. In extreme cases it can lead to self-harming and have a devastating effect on their educational attainment.

The benefits of early settlement of a compensation claim need to be carefully balanced against the risk of the child later developing a severe psychological disorder in their teenage years which could have long terms implications, and which would go uncompensated.

For more information, please do not hesitate to get in touch with our experienced team of medical negligence solicitors.

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About the author

clair hemming

Clair Hemming

Partner and Solicitor

Partner and solicitor in the medical negligence department and a member of the Devon & Exeter Medico Legal Society and the Law Society Clinical Negligence Panel