Medical Q&As

Erb's palsy - explain?

My 6-month-old baby does not seem to make proper use of his thumbs. He holds them at a ninety-degree angle and only rarely extends them fully. When he grasps an object, he appears to use his fingers only, most of the time. However, he is able to use his thumbs as he does so occasionally. I have taken him to my GP who identified the condition as Erbs' Palsy. I have also visited a physiotherapist with him but the only advice she could offer was to try and extend his thumbs as often as possible. This is quite difficult with a 6 month old who does not want you to go near his hands. My GP told me that this condition can result from a stressful birth. I had a 23-hour labour and then a caesarean section, and would like to know if this could be responsible for the condition? Also, you might give me an indication as to what I can do to help my baby, and as to whether his thumbs can eventually be expected to come right.

Erbís palsy is due to damage to the fifth and sixth cervical nerves. The degree of paralysis can vary greatly. The classic clinical sign of Erbís palsy is that the lower arm is rotated in what is colourfully described as the waiterís tip position. The nerves are damaged due to strain or traction on the neck and shoulder during labour. The majority of cases fully recover during infancy. Passive exercises such as have been recommended by the physiotherapist are an important mainstay of treatment. There is a very informative Irish website devoted to this topic, which I think you will find to be very helpful. It is run by Irish parents who have had experience of Erbís palsy. The site can be accessed at: