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Brachial Plexus Injury Solicitors - Medical Negligence Compensation Claim


If you or your child have suffered personal injury and you fear you may have been the victim of incompetence or negligence there is no time for delay. In order to know what options you have you should seek expert legal advice as soon as possible. Our medical negligence solicitors operate a service with no charge whereby you can meet us in person or chat over the telephone with one of our experts and obtain initial advice. If you subsequently decide to proceed no further then that is your right and you will not be charged for our bracial plexus injury solicitors initial advice.

Brachial Plexus Palsy

The brachial plexus is a network made up from a group of five large nerves (designated C5, C6, C7, C8 and T1) which branch out from the spinal cord and exit between the neck vertebrae (spinal column bones). The purpose of these nerves, some of which eventually terminate at the tips of the fingers, is to transmit micro electrical impulses thereby giving movement and feeling to the arm and hand. The physical arrangement of the network created by this group of nerves is complex and after coming out of the neck, the nerves come together, are then linked and then subsequently further divide before traveling along the muscles and tissues of the arm. The brachial plexus network is in position from the neck, passes under the collarbone and out along the arm at about the level of the armpit and is thus susceptible to injury caused by manual traction of an infants head during childbirth. Brachial plexus palsy injuries can also be caused by car, motorcycle or boating accidents; sports injuries; animal bites; gunshot or puncture wounds; as a result of specific medical treatments/procedures/surgeries or due to certain viral diseases. if you are suspicious about the cause of this injury just call the helpline to discuss with a brachial plexus palsy solicitor.

Obstetric Brachial Plexus Palsy

The term obstetric brachial plexus palsy refers to an injury to all or to a portion of a child's brachial plexus nerve network occurring at the time of delivery. This injury may be ccaused as a result of medical negligence and our brachial plexus injury solicitors are on hand to give you advice at no cost.

Injuries to the brachial plexus during childbirth are usually the result of excessive lateral traction on the head so that the head is pulled away from the shoulder. This force produces four distinct types of nerve injuries: an avulsion, a rupture, a neuroma and a neuropraxia.

An avulsion is the most severe form of injury, where the nerve root actually gets torn away from the spinal cord. In a nerve rupture, the nerve is torn but not at the level of the spinal cord. In a neuroma, the nerve has torn and healed but the scar tissue exerts pressure on the nerve and prevents it from properly conducting nerve signals to the muscles. Neuropraxia or stretch occurs when a nerve has been damaged but not torn. Of the four types of nerve injuries, neuropraxia is the most common form of brachial plexus injury.

The following conditions are known risk factors for obstetric brachial plexus palsy:

    • Cephalopelvic disproportion - a condition in which there is a disproportion between the size of the fetal head and the maternal pelvis such that the maternal pelvis is inadequate for passage of the fetal head during delivery.
    • A large or a macrosomic baby (a baby with a birth weight more than 4.0kg).
    • Instrumental delivery (especially from use of forceps during delivery).
    • Breech delivery.
    • Delivery of a premature - a premature baby is one delivered before 37 completed weeks of gestation. They are at an increased risk of developing brachial plexus injuries because of their fragile bodies.
    • Shoulder dystocia.
    • Primigravida - first timers have an untried pelvis and as such, there is a possibility of nerve injury occurring during delivery.
    • Prolonged labour.
    • Congenital anomalies - including hydrocephalus.

Managing obstetric brachial plexus palsy:

    • Most cases of obstetric brachial plexus injury resolve spontaneously in a little as 4 months or as much as 2 year after delivery.
    • X-rays to exclude fractures and examination for phrenic nerve paresis are important.
    • Other investigations that could be carried out include MRI, electromyography, nerve conduction studies and CT myography.
    • To prevent contractures, the affected arm should be immobilized across the upper abdomen for 7 days after which, physiotherapy using wrist splits should be commenced.
    • Surgery should be considered if movement does not return after 3 months and electrophysiology results indicate a poor prognosis.

Nerve Injury

If brachial plexus paralysis is caused during the process of birth it is known as obstetric brachial plexus palsy (which includes Erbs palsy) and these injuries are classified according to the severity of the injury starting with first degree or neurapraxia, in which the insulation around the nerve called myelin is damaged but the nerve itself is spared through three more increasingly severe stages to fifth degree injuries in which the nerve is completely severed. The severity of a brachial plexus injury depends on a number of factors the most important of which is the number of nerves that have been affected. Of the group of five nerves that can potentially be involved the ones that are most often damaged are the nerves exiting at C5 and C6 which cause the classic 'waiters tip' position of the hand and arm. If all five nerves are affected there may be weakness or paralysis of the entire arm and hand and there may also be an associated Horners syndrome causing the eyelid to droop and the pupil in the eye may be smaller. In addition the condition known as torticollis may be present where the baby faces away from their affected arm and is unable to face forward for any length of time. The next most important factor is the degree of damage suffered by the nerves which are outlined below :-

    Avulsion :-

      This occurs when the nerve is torn from the spinal cord and there is a complete separation or severing. There is no way in which this major injury can be surgically repaired. This is the most severe type of injury and function is completely lost with no hope of recovery.

    Rupture :-

      This occurs when the nerve is torn but not completely severed and there is some chance of a successful surgical repair. There is however no guarantee that full function will be recovered after repair however techniques and success rates are improving year on year.

    Stretching :-

      This often causes damage and injury to the nerves however there is a possibility that there will be spontaneous recovery and that healing will occur without medical intervention.

    Scarring :-

      This can occur on the site of an injury and is known as a neuroma which may interfere with the electrical signals passing along the nerve thereby causing loss of some function to a greater or lesser degree. It may be possible to surgically remove any scar tissue to improve or fully recover motor function.


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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here