Chater Michael, Camfield Peter, Camfield Carol
Department of Pediatrics, Dalhousie University and the IWK Health Centre, Halifax, Nova Scotia.
Paediatr Child Health. 2004 Oct;9(8):556-560. doi: 10.1093/pch/9.8.556.
Erb's palsy is initially frightening. The infant's arm hangs limply from the shoulder with flexion of the wrist and fingers due to weakness of muscles innervated by cervical roots C5 and C6. Risk factors are macrosomia (large baby) and shoulder dystocia. However, Erb's palsy may occur following cesarian section. The experience of the delivering physician may not influence the risk of Erb's palsy (0.9 to 2.6 per 1000 live births). Differential diagnosis includes clavicular fracture, osteomyelitis and septic arthritis. Fortunately, the rate of complete recovery is 80% to 96%, especially if improvement begins in the first two weeks. Recommended treatment includes early immobilization followed by passive and active range of motion exercises (although there is no proof that any intervention is effective). For the few infants with no recovery by three to five months, surgical exploration of the brachial plexus may improve the outcome. Three infants with Erb's palsy who illustrate variations in the evolution of this disorder are presented.
臂丛神经麻痹初起时令人惊恐。由于颈5和颈6神经根支配的肌肉无力，婴儿的手臂因手腕和手指屈曲而从肩部无力地垂下。危险因素包括巨大儿（大婴儿）和肩难产。然而，臂丛神经麻痹也可能在剖宫产术后发生。接生医生的经验可能不会影响臂丛神经麻痹的风险（每1000例活产中有0.9至2.6例）。鉴别诊断包括锁骨骨折、骨髓炎和化脓性关节炎。幸运的是，完全恢复率为80%至96%，尤其是在最初两周内开始改善的情况下。推荐的治疗方法包括早期固定，随后进行被动和主动的活动范围练习（尽管没有证据表明任何干预措施有效）。对于三到五个月仍未恢复的少数婴儿，臂丛神经的手术探查可能会改善预后。本文介绍了三名臂丛神经麻痹婴儿，以说明这种疾病演变过程中的差异。
