William Smellie, a British obstetrician is credited
with the first medical description of obstetric
brachial plexus palsy.
1861- Benjamin Amand Duchenne coined term
‘obstetric palsy of the brachial plexus’
1874 - Wilhelm Heinrich Erb concluded his thesis
on adult brachial plexus injuries
Mechanism of injury
Pulling up of the
arm above the
head, so that
stretch on the C8
and T1 roots
Inferior trunk ( C8,T1)
Radial nerve, ulna nerve, the
thoracodorsal nerve, median nerve
and the medial pectoral nerve.
Ulnar side of the
forearm and hand
Pronators of the forearm
Flexors of the wrist joint.
Bernard-Horner syndrome and oculo-
Injury to cervical sympathetic ganglions.
Enophthalmos, partial ptosis, swelling of
the lower eyelid, miosis , unhydrosis and
Loss of ciliospinal reflex.
Fracture of the clavicle
Fracture of the humerus
Subluxation of the cervical spine
Cervical cord injury
Facial nerve palsy
Phrenic nerve palsy
X-rays to exclude fractures and examination
for phrenic nerve paresis are important.
Other investigations -
Nerve conduction studies,
CT myography and
Most cases of OBPI resolve spontaneously
in ~ 4 months to 2 year after delivery.
To prevent contractures, physiotherapy
using wrist splits after 7days
Surgery if movement doesn’t return after 3
months and electrophysiology indicate a