Klumpke paralysis is a neuropathy of the lower brachial plexus which may be resulted from a difficult delivery].
The eighth cervical and first thoracic nerves are injured either before or after they have joined to form the lower trunk. This injury can cause a stretching (neuropraxia,), tearing (called “avulsion” when the tear is at the spine, and “rupture” when it is not), or scarring (neuroma) of the brachial plexus nerves.
Most infants with Klumpke paralysis have the more mild form of injury (neuropraxia) and often recover within 6 months.
Hyper-abduction traction depending on the intensity ,cause sins and symptoms conistent with the neurological insult.
Klumpke’s palsy symptoms include:
Klumpke’s palsy can be caused by a difficult childbirth. It usually occurs during vaginal deliveries, especially in cases where the mother is small and the baby has a large birth weight. Large birth weight in a baby can occur due to poorly managed maternal diabetes or gestational diabetes. This birth injury sometimes occurs when the baby is pulled from the birth canal by an extended arm above the baby’s head. If done too roughly, this can injure the lower brachial plexus. Injuries are similar to those that occur in Erb’s palsy.
Klumpke’s palsy can also be caused by tumors in the area of the upper lung and collarbone which compress or stretch the nerves to the arm. It can also be caused by trauma to the arm and shoulder, such as force to the arm or shoulder when catching oneself during a fall.
The risk of Klumpke’s palsy can be minimized by:
Advanced planning: If the baby is larger than usual or in the incorrect position in the weeks leading up to the due date, advanced planning by the obstetrician to prevent Klumpke’s palsy should include insuring qualified personnel are present in the delivery room, proper use of birthing instruments and extractors, and induction of labor or Cesarean delivery if several risk factors are identified.
Maternal healthcare: Good maternal healthcare during pregnancy, including avoidance or control of diabetes, can help prevent Klumpke’s palsy.
In most cases, a baby will recover from Klumpke’s palsy within six months. In more severe cases, in which there is tearing of the nerve(s) – especially away from the spine – symptoms may last for years or children may experience lifelong disabilities of the arm, hand or fingers.
Treatment of Klumpke’s palsy may include:
Systematic review indicated that physiotherapy interventions like constraint-induced movement therapy, kinesiotape, electrotherapy, virtual reality and use of splints or orthotics have positive outcomes for the affected upper limb functionality in obstetric brachial palsy from 0 to 10 years
Surgical Procedures If physical therapy doesn’t show promising results after three to six months, your physician may recommend surgery to repair injury to the affected nerves. This may include: