Erbs Palsy

Once we have received a referral for your child we will aim to offer you an appointment when your child is 12 weeks of age. During this appointment you may meet several members of our MDT (multi-disciplinary team). We will ask you questions regarding your pregnancy, delivery and what movements you have noticed occurring in their affected arm.

We will examine your child including observing the movements of their affected arm. Following the assessment a treatment plan for your child will be formulated and discussed with you. This may include specific exercises and/or surgery to repair the damaged nerves.

If you child is referred after 12 weeks of age we will offer you the next available appointment to attend an outpatient clinic. In clinic you will meet the MDT and undertake a similar assessment. Depending on your child’s age we will also assess their function.

Primary Surgery

If your child requires primary nerve surgery we will aim to do this before they are 6 months of age. They will be given a date for surgery and admitted to the children’s ward. One parent will be allowed to stay overnight with their child whilst they are in hospital.

All surgery is performed under a general anaesthetic and the surgeon will initially examine the nerves to establish the extent of damage. If the nerve is found to be damaged then this part is removed and replaced with a healthy nerve taken from the back of your child’s legs or arm (which is less important) to bridge the gap.

If the nerves have been avulsed (pulled out) from the spinal cord, then nerves from adjacent areas (which do less important jobs) inside and around the plexus will be transferred to aid function to the arm.

After surgery your child’s arm (and legs if grafted) will be bandaged. The arm bandage will also limit any movement of their arm to protect the repair of the nerves. Your child will usually be allowed home after a few days but it is important that the arm bandage stays in place until your next hospital appointment.

You will return to an outpatient dressing appointment 4 to 6 weeks after surgery to remove the bandages and re-start exercises. This may be face to face in clinic or via a video consultation.

The nerve grafts or nerve transfers will all take many months or even over a year before they start to show signs of recovery.

Secondary Surgery

Sometimes it is necessary to perform surgery when your child is a little bit older. This may include releasing tight muscles (subscapularis release) or to help weaker muscles by means of muscle or tendon transfers. We will discuss with you and your child at each stage the reasons why this maybe considered and the benefits this could offer.

The physiotherapy team will initially assess your child’s arm and discuss with you their findings. We will use a combination of exercises to maintain their joint movement and to strengthen their muscles. We will instruct you in how to perform these exercises as part of a home exercise regimen. Providing information on their injury, treatment and the rehabilitation process is also an important part of the therapy sessions.

You will be continually monitored either in the consultant outpatient clinics or with regular physiotherapy appointments. The overall aim at all stages is to help your child with their recovery and to improve the movement, strength and function of their arm based on their individual needs.

The birth of a baby with OBPP can be a traumatic and distressing time and you may go through a range of emotional reactions. In time, your child may also need to adjust to the effects of their injury. The psychologists in the team are used to seeing families in this situation and understand that it takes time to adjust.

You may see the clinical psychologists when you attend the outpatient clinic, on the ward or as an outpatient within their department.

If you feel that yourself or your child would benefit from this service please speak to any member of the team.

Occupational therapy (OT) will aim to promote the maximum level of functional independence for your child. The OT will assess your child’s functional abilities and any difficulties they have in daily and school life. They may also provide your child with a splint to support or gain the best possible function of their arm.

If you live outside of the Leeds area they will liaise with your local teams and review you regularly when you attend your consultant clinics.