Erb's Palsy (Brachial Plexus and Shoulder Dystocia)
Introduction
A professional colleague and friend's wife gave birth to a baby who
was damaged during birth. The shoulder of the baby was caught on
part of the pelvis as it was passing through the birth canal.
The result was that the baby could not move one of its arms.
This Web page lists resources that may be useful to parents of
children who experience the same problem which is called Erb's palsy
or shoulder dystocia. If you know of additional resources that
should be listed here, please send them to
Max Lent.
Links
Advice
Art, medical and legal
Articles
Bulletin Boards
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Family and Personal Web sites related to brachial plexus
Hospitals that deal with brachial plexus and shoulder dystocia injuries
- Beth Israel Medical Center, Singer Division, New York,
NY. The Hyman-Newman Institute for Neurology and Neurosurgery. The Center for Functional Restoration.
- Children’s Healthcare of Atlanta. "The Neurology
Clinic at Children’s at Scottish Rite offers initial diagnosis for any child, from birth to age 21, for evaluation of a
possible neurological disorder. Treatment and follow-up services are provided for those children who have been diagnosed..."
- Children's Hospital of Pittsburgh. "The Center for
Brachial Plexus and Peripheral Nerve Injuries provides multidisciplinary evaluation and treatment of children with all types
of brachial plexus and peripheral nerve injuries. Members of the center’s multidisciplinary team include specialists in
neurosurgery, micro/hand surgery, neurology, physical and occupational therapy, neuroradiology and clinical social work. Team
members are available during the patient’s appointment to maximize the efficiency of the patient’s evaluation and to
facilitate collaboration of the different specialists. Patients with injuries to the brachial plexus and peripheral nerves
benefit from this approach by receiving comprehensive medical, surgical and psychosocial information throughout their ongoing
evaluation."
- Children's Mercy Hospital. Use their Web site search engine and key in the
word brachial.
- Gillette Children's Specialty Healthcare.
- John's Hopkins Medicine.
- Lucile Packard
Children's Hospital. "Pediatric Neurosurgery at Lucile Packard Children's Hospital treats infants and children with
disorders affecting the central and peripheral nervous system."
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Medical College of Georgia. "Parents and
physicians who have questions regarding the care of the infant with Brachial Plexus are encouraged to contact the Brachial
Plexus team at 706-721-5568 or e-mail at aflanner@mail.mcg.edu."
- Medical College of Wisconsin. Brachial Plexus
Clinic. "The Brachial Plexus Clinic is a multi-specialty clinic for the evaluation and treatment of patients with
obstetrical brachial plexus palsy.
The majority of patients with this diagnosis may improve with therapy intervention and
monitoring by specialists for spontaneous recovery. For those patients with more serious injuries, surgery may be necessary
to improve function. Ideally this surgery must be performed before the child reaches one year of age. Reconstructive surgery
may be considered as a later option."
- The Methodist Hospital, The Neurosurgery Center.
"Today, the service is recognized worldwide for the excellent patient care it provides and for comprehensive research
programs, particularly in the areas of severe head trauma and ruptured aneurysms.
The service offers the full range of modern neurosurgical techniques. The sophisticated imaging facilities available at The
Methodist Hospital, including CT, MR, and SPECT scanning, MR angiography, cerebral angiography with three-dimensional
reconstruction greatly assist physicians in their pre-operative diagnosis, surgical planning and follow-up."
- Miami Children's Hospital, Pediatric Upper
Extremity Program. "Miami Children's Hospital, through its multidisciplinary Pediatric Upper Extremity Program,
provides comprehensive care and rehabilitation for infants, children and young adults with congenital and acquired disorders
of the upper limb."
- New York University Medical Center, NYU Division of Pediatric
Neurosurgery. "The NYU Division of Pediatric Neurosurgery is one of the leading referral centers for the surgical
treatment of infants , children, and adolescents with neurological problems. Based at New York University Medical Center, a
major academic medical center on Manhattan's East Side, the Division offers comprehensive care for children with brain and
spinal tumors, hydrocephalus, spina bifida, epilepsy, cerebrovascular disorders, Chiari malformations, tethered spinal cord,
head injury, cerebral palsy/spasticity, peripheral nerve/brachial plexus disorders, craniofacial syndromes/craniosynostosis,
and spinal conditions."
- St. Louis Children's Hospital, Brachial Plexus Palsy Center. "Since
1991, our Brachial Plexus Palsy Center at the St. Louis Children's Hospital has evaluated and treated more than 200 children
with birth brachial plexus injury. At our multidisciplinary Center, children are examined by a team of pediatric
neurosurgeons, neurologists, and therapists. An orthopaedic surgeon specializing in hand surgery and a pediatric neurologist
also work with children who have persistent muscle weakness."
- Texas Children's Hospital.
Texas Children's Brachial Plexus Center.
"In our experience, obstetric injuries to the brachial plexus usually cause significant functional deficits if not managed
correctly. It is essential to seek evaluation by physicians experienced in the treatment of children with these injuries in
order to optimize the overall outcome. It is NOT a sufficient answer for an evaluating physician to say "95% of these
injuries get better" (see article in this brochure entitled "Long-term Outcome after Obstetric Brachial Plexus Injury"); it
is not appropriate to deny physical therapy; it is not true that "surgery doesn't help"; and it is not "only an arm". It is a
significant functional injury that often is permanently disabling, and can affect employment, health, and future
socioeconomic status."
- The Yale Brachial Plexus Center. "Our close
proximity to the Yale Children's Hospital allows us to combine talents with the state-of-the-art anesthetic, physical therapy
and pediatric teams for diagnosis and management of brachial plexus palsy. Most often, newborns will regenerate injured
nerves, and surgery is rarely necessary. If recovery is not in evidence within three months of birth, we can perform
additional testing under light anesthesia as an outpatient procedure to help determine the extent of nerve and spinal cord
involvement. If necessary, surgery can be safely performed as early as 3-6 months of age to repair damaged or ruptured
nerves. In an older child with incomplete recovery, tendon transfers can be performed to restore balance and function to the
shoulder. As a rule, children have the best regenerative capacity after brachial plexus injury because of the plasticity of
their neural tissues, their boundless optimism, and their will to recover.
Legal Resources
Please be very cautious of contacting the legal resources listed below. These are included here because you will probably
find them elsewhere. Being listed here is not a recommendation.
- The Buckingham Law Firm. Also listed as medmal-law.com.
- Erb's-Palsy-Help.com. This Web site is sponsored by an
unnamed law firm. The fact that the law firm keeps its name secret raises immediate suspicions about the firm's
credibility and of the information published here. I was not able to find a law firm at this address, so beware of
contacting this resource. The following is information I was able to obtain about the owner of this Web site:
Contact's email address: selinger6@aol.com ( a non-working email address)
Erb's Palsy Legal Help
177 Main St., Fort Lee, NJ. 07024-6936
Fax: 419 730 5437
- Anthony Mancini & Associates. "Attorney's Representing
Children Injured at Birth." "If your child or a loved one's child was injured at birth it may have been the result of
medical negligence. Our Law Firm has succesfully helped children and families nationwide, who are victims of birth
malpractice, secure substantial settlements and judgments, thereby providing the injured child with the resources necessary
to assist with his or her special needs throughout their lives."
- Ken Sigelman, J.D., M.D., A medical doctor and a lawyer. My impression
is that this site is a commercial extension of the medical malpractice side of Dr. Sigelman's business.
- Jason A. Weachter. 800-708-5433. Based on Weachter's Web site, this
appears to be another referral service.
- Kathleen T. Zeller.
Brachial Plexus Page. This lawyer appears to have excellent
credentials.
Mailing lists
News
- One of the best sources of delivered news on a topic is
Google.com's News Alerts.
Go to the URL add the key words and your email address. You
will then receive by email the latest breaking stories on the topic
you select. In this case the topics would include Erb's Palsy,
Brachial Plexus, and so on.
Organizations
- Brachial Plexus Palsy Foundation. "Enclosed in this website is a description
of a brachial plexus injury and other information to better educate families who do not have the time or resources.
Along with providing families across the world with a package of information, we also provide information on the Internet
through this site. The site describes, in detail, what a brachial plexus injury is, how it is treated and what kinds of
therapy are involved. We have provided information via the world wide web for people all over the world, every day."
- Gentle Birth. Shoulder Dystocia.
- injurednewborn.com. An excellent Web site with a large amount of practical
information.
- National Brachial Plexus/Erb's Palsy Association, Inc.
- The National Information Center for Children and Youth with Disabilities. "NICHCY
is the national information and referral center that provides information on disabilities and disability-related issues for
families, educators, and other professionals. Our special focus is children and youth (birth to age 22)."
New York State resources.
- National Institute of Neurological
Disorders and Stroke.
- National Organization for Rare Disorders (NORD). NINDS Brachial Plexus
Injuries Information Page.
- National Rehabilitation Information Center.(NARIC).
- Shoulderdystocia.com.
- United Brachial Plexus Network, Inc. "The United Brachial Plexus Network (UBPN)
is a registered non-profit 501(c)3 organization devoted to providing information, support and leadership for families and
those concerned with brachial plexus injuries worldwide. Available resources include: Our extensive website; Online registry,
various outreach and awareness programs, and Outreach, our in-depth publication. Beginning in 2000, UBPN will also produce an
annual comprehensive Resource Directory."
Other Web resource directories
Physicians
- Dr. Allan J. Belzberg. "Dr. Allan J. Belzberg, of the
Johns Hopkins Neurosurgery Department, is one of only a handful of doctors in the country who perform brachial plexus repair
operations: 'When a nerve is pulled right out of the spinal cord, we have to use a new piece of nerve that's still working,
so we take the nerve from somewhere else around your neck that's still working and we make that nerve do something new.'"
- John A. I. Grossman, M.D., F.A.C.S. "Our medical staff has
extensive experience in diagnosing and treating hand and nerve disorders and injuries. Here you will find information on our
staff credentials and education."
- David G. Kline, M.D. "LSU Neurosurgery."
- Julia K. Terzis, M.D., Ph,D. Dr. Terzis "is recognized worldwide
for her contributions to the field of Restorative Microsurgery and treatment of peripheral nerve paralysis."
Publications
Newsletter
- Outreach. "The Outreach publication is
produced and distributed by UBPN roughly twice per year depending on news and need. UBPN has recently supplemented this
full, magazine-style publication with "Outreach In Brief": a short newsletter (without feature articles) focusing
primarily on current news and upcoming events of note."
- Special Child.
Poems and Writings
Support groups
- Helping Hands. ""Helping Hands email", in the Greater Northwest with
my friend, Julia Aten. The first two years it was just the two of us. Now, sadly enough, there are 42 families (that we
know of) in our state that are affected by Brachial Plexus Palsy. There are a dozen in Oregon and much more in the
surrounding areas. I am happy to share any and all information with any family within or outside of our area."
Online
Technology
- Mayatek. "Mayatek is the only approved supplier of equipment for Threshold ESTM. Our stimulators have been used for
nearly ten years to implement the Threshold Electrical Stimulation [TES] program used to counteract disuse muscle atrophy.
Over 8,000 children and adults with a wide range of disorders including cerebral palsy and spina bifida have used Threshold
ES as a complement to physical therapy. Upwards of 1,000 therapists, physicians and nurses from forty-seven states and
seventeen countries have completed courses in its application."
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