The Brachial Plexus and Peripheral Nerve Program at Children's Health℠ is the only one in the region offering comprehensive care for children with brachial plexus nerve injuries. We specialize in complex nerve surgeries, physical rehabilitation and occupational therapy for newborns through age 18. With our team approach, we bring together experts in physical medicine and rehabilitation, hand surgery and occupational therapy to meet all of your child’s needs.
Brachial plexus injuries may happen to infants during childbirth or to older children in an accident. These injuries affect the brachial plexus nerves, which provide movement and feeling to your child’s shoulder, arm and hand. This network of nerves starts at the spinal cord in the neck and travels down each shoulder and arm to the hands. Pediatric brachial plexus birth injuries occur when these nerves stretch or tear. The injury typically only affects one side of a child’s body.
Children with brachial plexus nerve injuries may not be able to move or feel the injured hand, arm or shoulder. Other names for brachial plexus nerve injuries include brachial plexus palsy and Erb’s palsy.
This injury occurs when the nerve stretches, causing swelling. The damaged nerve can’t send signals to the brain to help move the shoulder, arm or hand. The inflammation also affects your child’s ability to feel sensations with their injured hand and arm.
Children with a stretch injury (neuropraxia) eventually regain limb movement and sensation after the swelling goes away, which may take up to three months. During this time, your child receives occupational therapy through our Pediatric Hand Therapy Program.
A rupture is a partial or complete tear within a brachial plexus nerve. As the swelling subsides during your child’s first four months of life, you’ll notice some movement returning to the injured limb. It can take 12 to 18 months for the nerve to mostly recover and regenerate. However, it’s rare for a nerve to fully recover from this type of injury.
During this time, our occupational therapists perform exercises to keep your child’s unused muscles and joints from stiffening. We show you how to do these stretching and strengthening exercises at home. If there’s no noticeable improvement in limb movement or sensation by the time your child is 4 months old, we perform surgery to repair the injured nerves.
Avulsion is the result of the root of the brachial plexus nerve tearing away from the spinal cord. If there’s no noticeable improvement in limb movement or sensation by the time your child is four months old, we perform surgery to repair the tear.
Brachial plexus nerve injury symptoms are noticeable soon after birth. A newborn may have:
Your pediatrician may diagnose a brachial plexus birth injury based on symptoms and order an X-ray to check for a collarbone fracture. These diagnostic steps often take place before you and your baby leave the hospital. Fractures sometimes occur along with nerve injuries and require treatment such as a sling.
After diagnosis, your pediatrician may refer your family to Children’s Health for ongoing care. Pediatricians throughout the region refer families to us for our expertise in helping children with brachial plexus nerve injuries regain limb function.
Traction on the nerves during childbirth causes brachial plexus birth injuries. A brachial plexus nerve injury is more likely to occur when a baby’s shoulders become stuck behind the mother’s pubic bones after the baby’s head comes out during a vaginal delivery. This problem is known as shoulder dystocia. The uterine contractions squeeze the shoulders. The pressure on the brachial plexus nerves can cause stretching or tearing.
We use a team approach to help children with brachial plexus nerve injuries recover arm and hand function. Our comprehensive treatments include:
We bring together experts in physical and rehabilitation medicine, hand surgery and occupational therapy to create a customized treatment plan for your child’s unique needs.
Children who have tears, ruptures or avulsions can have lifelong issues using the injured shoulder, arm and hand. At Children’s Health, we assess your child’s progress once or twice a year until they turn 18. When needed, we re-engage your child in occupational therapy and group activities that promote limb function.
Yes, brachial plexus injuries can occur during childhood as the result of an accident, fall or sports injury. Our Brachial Plexus Injury Program provides care for children of all ages for injuries with any cause. Because these injuries can be more painful for older children, we work with experts at our Chronic Pain Clinic to keep your child comfortable while they recover.