It is the clinical picture that occurs due to damage to the C5 C6 C7 C8 T1 roots that join the brachial plexus during birth, and the C4 and T2 roots, if there are any, and the nerves coming out of these roots.
The damage requires a force of 20 - 40 kg. . It often occurs when the neck and trunk bend excessively to the side or the head is pulled to the side during breech birth.
In our country, it is seen on average in 1 in 1000 live births. 90% of patients recover within the first 4 months. Respiratory problems may also accompany this disease. Early diagnosis is of great importance.
Brachial plexus consists of three large branches.
▪Lateral (upper)
▪Posterior (middle)
▪Medial(lower)
Stretch or ruptures may occur in one, two or all of these branches.
▶SYMPTOMS
The hand turns inwards and backwards. posture, tendency to turn the head to the opposite direction of the affected side, softness in the muscle of the affected arm, inability to grasp objects with that hand, inability to bring the hand to the mouth, swelling on the collarbone, delayed sitting balance, etc.
♦The upper and middle branches are most commonly affected. This injury is called ERB INJURY. The arm is adjacent to the body, with the palm facing backwards.
♦ KLUMPKE INJURY is an injury that affects only the lower branch and is rare. The inner muscles of the hand were affected. This may be accompanied by Horner syndrome, which is characterized by drooping eyelids and loss of sweating.
♦TOTAL INJURY All 3 branches are also affected. It is also accompanied by Horner syndrome.
The involvement may be unilateral (one-sided) or bilateral (double-sided).
▶RISK FACTORS
➖Diabetes
➖Obesity
➖Excessive weight gain
➖Mother's age over 35
➖First birth
➖ Pelvis (pelvis) stenosis
➖Baby's posture during birth
▶FORMS OF INJURY
▪Neurapraxia; just nervous tension. With regular physiotherapy, recovery occurs in an average of 21 days.
▪Axonotmesis; Deterioration in nerve integrity. Movement usually begins within about 1 year, without the need for surgery. It is important that the exercises are bilateral. It can be overcome with minor losses.
▪Neuromesis; Nerve integrity is completely damaged �. It usually requires a long physiotherapy period after surgery.
〰Surgical: nerve transplants, muscle tendon transfers. It is necessary in cases where there is no improvement within the first few months.
〰Physiotherapy: Nerve rehabilitation performed by the physiotherapist is performed with personalized exercises, electrotherapy and kinesiological tapes.
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