SHOULDER DYSTOCIA RECOVERY

The most common fetal injuries caused by shoulder dystocia occur to the clavicle and brachial plexus.

An Injury to the Brachial Plexus

The most common injury that requires recovery from an infant shoulder nerve injury happens to the brachial plexus. Spinal cord segment nerve roots become damaged to produce one of two types of palsy: Erb or Klumpke. An injury to the upper trunk of the brachial plexus causes the more common Erb palsy. Erb palsy prompts damage to the upper arm muscles because of the unusual positioning of the scapula. An infant might experience damage to the supinator and/or extensor muscles found in both wrists. The result is a wrist configuration that creates what health care professionals refer to as the “Waiter’s Tip” position. Klumpke palsy causes lower trunk lesions in the one or both elbows, depending on the number of shoulders stuck in the birth canal.

Painful Fractured Clavicle

As the second most common injury caused by shoulder dystocia, the rate of fractured clavicles is about 10% for all infants that suffer from shoulder nerve damage. If an infant’s chest and shoulders are too large in relation to the size of the mother’s pelvis, doctors must apply more force than they want to get the infant to move through the birth canal. The extra force can fracture an infant’s delicate clavicle. Broken clavicle ends that overlap allows doctors to deliver an infant who experiences a stuck shoulder during birth delivery. Clavicle fractures occur in around 0.3% of all infant deliveries.

Recovery from Shoulder Dystocia

Most brachial plexus injuries recover over several months, with a few cases requiring a full year to heal the brachial plexus. Within two to four weeks after birth, health care professionals implement physical therapy exercises to enhance the strength of the affected muscles that received nerve damage. Permanent injuries to the brachial plexus require more physical therapy exercises for healthy muscles that surround the damaged muscles. Stronger muscles located adjacent to the damaged muscles can enhance the movement of the arm, hand, elbow, and/or shoulder. Surgical therapy, such as the grafting of nerves and the transposition of muscles, might alleviate some of the permanent nerve damage caused by shoulder dystocia. Many orthopedic surgeons and neurosurgeons who perform surgical therapy operations report varying degrees of success for improving permanently damaged nerves. However, some orthopedic surgeons and neurosurgeons contest the positive results reported by many of their peers.

Why a Prompt Diagnosis Matters

The key to any type of shoulder dystocia recovery is the prompt diagnosis of the medical disorder. Doctors immediately diagnose shoulder nerve damage when they see an infant’s head pop out of the birth canal, but the shoulders do not follow suit. This means an infant’s shoulders have become stuck in the birth canal, which places both the infant and mother at risk of incurring serious to life-threatening injuries. Doctors have to find a subtle way to move infants through the birth canal to prevent injuries such as a fractured clavicle or damaged brachial plexus.