Birth Injuries Involving the Brachial Plexus

Jacky Gale | August 9th, 2013

Brachial Plexus Birth InjuryA brachial plexus birth injury involves traumatic damage to the bundle of nerves located around the shoulder of the newborn. This nerve network transmits electrical impulses from the spine to the hand, arm, and shoulder. The stretching or tearing of these sensitive nerve fibers results in a brachial plexus injury. According to some estimates, approximately two out of every 1,000 births in the U.S. involves a brachial plexus injury.

Types of brachial plexus injuries

There are a few different types of brachial plexus birth injuries, all of which involve symptoms such as loss of sensation, weakness, and partial or total paralysis. A nerve rupture occurs when the nerves are torn, rather than stretched. A nerve tear is less likely to heal than stretching of the nerves. Avulsion of the brachial plexus means that the nerves have entirely separated from the spine. This is among the most severe types of brachial plexus injuries. Doctors are usually unable to fully repair the damage with a donor nerve graft. Another type of brachial plexus injury with a very bleak prognosis is neurotemesis, which means that the whole nerve has been divided. If the axons of the nerves are divided, it is called axonotemesis.

When the nerves stretch, rather than tear, it may be diagnosed as neurapraxia. Most infants with neurapraxia recover from the injury rapidly. Physical rehabilitation therapy is likely required.

Doctors also classify brachial plexus injuries according to which part of the anatomy is affected by the nerve damage. For example, Erb’s palsy refers to a loss of sensation and movement in the shoulder. If the infant loses motion in the hand and wrist due to trauma of the lower brachial plexus, this is known as Klumpke’s palsy.

Long-term complications

Although a mild brachial plexus birth injury is likely to heal, infants with moderate to severe trauma are at risk of further complications. Since nerves affect the growth of the child, parents may notice that one arm is smaller than the other. As the child grows up, the difference becomes more noticeable.

Mobility issues in the affected hand, arm, and shoulder typically lead to overcompensation in the other arm. The child must rely on the unaffected arm to complete tasks. This places the unaffected arm at an increased risk of repetitive motion injuries, which may include carpal tunnel syndrome, bursitis, and tendonitis. Arthritis is also more common in both limbs.

Causes of brachial plexus injuries

When a newborn is diagnosed with a brachial plexus injury, it is typically the result of a difficult delivery. Prolonged labor, a breech presentation, and a large size of the child are risk factors for these injuries. This is one reason why it’s critical for the attending healthcare professionals to recommend a cesarean section if these risk factors are noted. Healthcare professionals who fail to perform C-sections in a timely manner may be held liable for medical negligence. Another example of negligence during delivery that can cause a brachial plexus birth injury is the improper use of forceps, vacuums, and other devices used to assist labor.

Consulting a New York birth injury lawyer

New Yorkers who believe their children have been the victims of medical malpractice can attempt to recover damages by filing a birth injury lawsuit. Compensatory damages can cover medical bills, rehabilitative expenses, and long-term care needs. Contact The Sanders Firm today to discuss your legal rights and options. Our legal team has more than four decades of experience in birth injury malpractice litigation. We proudly serve residents of the Queens, Bronx, Brooklyn, Long Island, Staten Island, and Manhattan areas. For a free case evaluation, call 1-800-FAIR-PLAY.


  1. Mayo Clinic, Brachial plexus injury, http://www.mayoclinic.com/health/brachial-plexus-injury/DS00897/METHOD=print

  2. Johns Hopkins Medicine, Brachial Plexus Injury (BPI), http://www.hopkinsmedicine.org/neurology_neurosurgery/specialty_areas/peripheral_nerve_surgery/conditions/brachial_plexus_injury_bpi.html

  3. United Brachial Plexus Network, Inc., About Traumatic Brachial Plexus Injuries, http://www.ubpn.org/resources/traumatic