Klumpke’s paralysis involves the following EXCEPT
Correct Answer: C6
Description: Ans. a (C6) (Ref. BDC 4th/Vol. 1 53)BRACHIAL PLEXUS INJURIES# Brachial plexus palsy due to birth injury has three general patterns of involvement:- Erb's palsy, involving C5 and C6 roots;- Klumpke's paralysis, involving C8 and Tl; and- Whole arm paralysis, where the extent of involvement of individual roots may vary.Erb's Palsy# It is most common injury.# It affects the shoulder, with loss of extension, abduction, and external rotation.# Also affected are elbow flexion and forearm supination.# Spontaneous improvement will occur and will level off by age IV2 years.# MRI is excellent for diagnosis.# Initial Rx is directed at maintaining shoulder motion by positioning and passive stretching to prevent the characteristic contracture in adduction and internal rotation.# If muscle imbalance persists at the shoulder, the pectoralis major and subscapularis muscles can be lengthened with posterior transfer of the latissimus dorsi and teres major muscles, so that they become external rotators.# Humeral osteotomy may be preferable to tendon transfer when the shoulder joint is unstable. Traction or tear of the upper trunk of the brachial plexus (C5 and C6 roots); follows blow to shoulder or trauma during delivery Finding; limb hangs by side (paralysis of abductors), medially rotated (paralysis of lateral rotators), forearm is pronated (loss of biceps)."Waiter's tip" owing to appearance of armAn embryologic defect; can compress subclavian artery and inferior trunk of brachial plexus (C8, Tl) resulting in thoracic outlet syndrome: 1. Atrophy of the thenar and hypothenar eminences 2. Atrophy of the interosseous muscles 3. Sensory deficits on the medial side of the forearm and hand 4. Disappearance of the radial pulse upon moving the head towards the opposite side
Category:
Orthopaedics
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