Obstetric paralysis

Description:

Various disturbances of motive function of hands which arose owing to natal damage of peripheral motive neurone.

Reasons of obstetric paralysis:

Sluggish paralysis of muscles of upper extremities at newborns is caused by a birth trauma of a brachial plexus or nervous roots forming it. It is promoted by difficult and long childbirth, discrepancy of the size of a fruit to a parturient canal, pathological presentation, use of various methods of an obstetric grant.

Simtoma of obstetric paralysis:

Partial or full loss of function of deltoid, two-headed, tricipital muscles of a shoulder, humeroradial, over - and podostny, front gear, small round is noted. Such disturbance is caused by damage of roots at the level of CV and CIV and corresponds to disturbance of conductivity of axillary, musculocutaneous and partially beam nerves. Depending on the level of defeat of a brachial plexus distinguish 3 types of paralysis: upper Dyushena-Erba paralysis, lower — Dezherin-Klyumpke, mixed (the Erba-type of Klyumpke and Klyumpke-Erba). At upper type which meets more often than lower the hand passively hangs down, the movements in it are absent or can remain only in a brush, the hand is usual also the rotirovana inside is brought to a trunk, and the brush is in the provision of a palmar inflection. The fold between a trunk and a shoulder is deepened. If to raise the child, the handle droops kzad. A muscle tone sluggish, the passive movements and joints are kept. At the lower paralysis there are no movements of a brush and fingers, the hand hangs down and the child carries it, supporting by a healthy hand. There comes the atrophy of small muscles of a brush (mm. interossei and lumbricales) owing to what proximal phalanxes adopt the provision of hyperextension, and distal are bent. The course of patrimonial paralysis depends on a damage rate of a brachial plexus. The irregularity of pupils, narrowing of a palpebral fissure, retraction of an eyeglobe (Horner's syndrome) depending on simultaneous damage of the sympathetic fibers knotted with the lower cervical sympathetic can accompany patrimonial paralysis.

Radiological reduction of a head of a shoulder is noted, with age an atrophy of muscles and bones of a segment on the party of damage accrue. The combination of this paralysis to a patrimonial fracture of a shoulder or clavicle or to shoulder dislocation meets.

Treatment of obstetric paralysis:

resort to operational treatment — change of muscles or an artificial ankylosis of a shoulder joint, the last intervention is made at children not earlier than 10-32-year age.

The forecast at early and correct treatment favorable.