Erb-Duchenne palsy is normally caused at birth and is an injury associated with the upper portion of the arm affecting the main group of nerves. The extent of the damage has a great deal to do with the type of treatment necessary for correcting it. Living with Erbs Palsy may result in temporary paralysis that can last only a few months, or require long term therapy and even surgery.

Most cases of this particular palsy are related to shoulder dystocia; arising from complications during childbirth. Shoulder dystocia occurs when the head is delivered but the shoulder is unable to pass through the pelvic bone without a great deal of manipulation. It is considered an emergency procedure at this point to assist with birth, as the situation can become fatal to the infant within approximately five minutes because of the constricted umbilical cord.

This condition can also result due to a serious fall during adulthood. Nerves can become severely stretched when a person falls to one specific side injuring the shoulder, head and neck. Correcting a dislocated shoulder and a gunshot wound may also have the same consequences.

There are three nerves most affected which include the axillary nerve, the suprascapular nerve and the musculocutaneous nerve. Damage with respect to each nerve can be either tearing or bruising. Partial or complete paralysis is possible as a result.

The Erbs Point is named after Wilhelm Heinrich Erb who was a German neurologist. This is the area that suffers damage and at this point six nerves are joined. Its location is just above the collar bone. All of the nerve fibers along the spine that continue through the neck, armpit and continue through the arm are included.

The signs associated with the condition can be anywhere from loss of sensation to complete paralysis due to weakening of specific muscles involved; deltoid, biceps and brachialis. The arm generally cannot be raised and remains in a position of hanging by the side rotated toward the front with the hand facing forward. This positioning is commonly referred to as waiters tip.

There are three common types of treatment including nerve transfers; nerves are taken from an opposite leg, latissimus dorsi tendon transfers and subscapularis releases. Due to possible nerve damage, nerve transplants are generally only done on infants that are less than nine months of age. At present age limitations are not a concern for other procedures.

Subscapularis release can be done on more than one occasion if necessary to increase the range of motion within the arm, but the muscle may be compromised. Increased sensitivity is possible with the latissimus dorsi tendon transfer due to the position in which the muscle will lie after surgery, but improved external rotation is given to the arm.

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