Part 1. Injuries to the Brachial Plexus: Mechanisms of Injury and Identification of Risk Factors

Kathleen Benjamin, RNC, MS, NNP


Adv Neonatal Care. 2005;5(4):181-189. 

In This Article

Classification of Brachial Plexus Injuries

Brachial plexus injuries are most often classified according to spinal nerve root involvement and into 3 main nerve groups:45

  1. Upper root injuries

    • Erb's palsy or Erb-Duchenne palsy;

    • Injury to C5 to C6 with shoulder and biceps weakness or paralysis;

    • Can involve C7 with forearm paralysis.

  2. Lower root injuries

    • Klumpke's palsy;

    • Paralysis of C8 to T1 (sometimes C7 also involved);

    • Weakness of distal upper extremity only.

  3. Complete or total nerve injury (second most common)

    • Erb-Klumpke's or total paralysis;

    • Involves the complete plexus (C5 to T1);

    • Associated with Horner's syndrome in one third of those severely affected.

The physical findings reflect the degree of muscle paralysis from specific spinal nerve injury and unaffected opposing muscle tone. The physical characteristics of each type of injury will be discussed in detail in part 2 of this article.


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