Forced extension of the arm over the head damages the lower plexus, with the intrinsic muscles of the hand being especially affected
- Damage to the brachial plexus lower roots
- Klumpkes palsy results from maximal abduction of the shoulder, causing injury to the lower brachial plexus (C8, T1) and leading to weakness and anaesthesia in a primarily ulnar distribution.
- Motor vehicle accident
- Direct trauma - knife or gunshot
- Brachial plexus injury also may be associated with Horner's syndrome, a fractured clavicle or humerus, subluxation of the shoulder or cervical spine, cervical cord injury, and facial palsy.
- Brachial plexus injury may also be associated with phrenic nerve injury and diaphragmatic paralysis which may need respiratory support in newborn
- Imaging and EMG/NC studies may be needed as well as plain films
- The affected arm is usually painful and should be immobilized across the upper abdomen for 7-10 days. Passive physiotherapy.
- Healing and functional return will depend on the severity of damage