Case No 9: Monoplegia of right arm (Erb's Palsy)

Arvind reported here with chief complaints of inability to use right arm effectively.

History :

There was a history of road traffic accident in 1991 leading to fracture of right forearm. It was treated with close reduction of right forearm. Now he is having difficulty in using his right arm effectively.

On investigation EMG study done on 25 Sept. 1991 was suggestive of total right brachial plexus lesion with almost complete axonotmesis in most of the muscles and partial but rather severe denervation in the median innervated and distal finger extensor muscles.

On examination marked restriction of all the movements of right shoulder, elbow and wrist was found with wasting of whole right upper limb. No sensory loss was reported.

Improvements with 6 months of G – Therapy :

1. Slightly better grip strength of right hand.
2. Better wrist flexion strength.
3. Better elbow flexion range now.
4. Started holding the handle of bicycle with right hand while ridding now.
5. Recent motor NCV study done on 27 Sept. 2001 is suggestive of patchy improvement in the right brachial plexus lesion.