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Klumpke palsy is a condition that affects the lower arm, wrist, and hand. It can occur in newborns who suffered nerve damage because of complications during labor and delivery. A baby with this condition may have anywhere from mild, temporary symptoms to a permanent disability, depending on the severity of damage to the nerves.
If you believe your child is suffering from Klumpke palsy because of mistakes made by a medical professional, you may have a case for medical malpractice. A lawyer specializing in birth injuries can explain your options and help you decide what to do next.
What is Klumpke’s Palsy?
Klumpke palsy is a condition, most often a birth injury, that results from damage to specific nerves of the brachial plexus. The brachial plexus nerves run from the spine, along the side of the neck, through the armpit area, and down the arm. They allow for movement and sensation in the arm, wrist, and hand.
When the nerves that run to a specific area in the lower part of the arm, mostly the wrist and hand, are damaged, the resulting injury is known as Klumpke palsy. This is a type of brachial plexus palsy, sometimes also referred to as Dejerine-Klumpke palsy.
In general, a palsy refers to a type of paralysis, although it does not necessarily mean complete paralysis. A palsy can cause a range of symptoms, from muscle weakness to uncontrolled movements to partial or total paralysis of muscles.
What Causes Klumpke Palsy?
The ultimate cause of Klumpke palsy is some degree of damage to the brachial plexus nerves. The types and degrees of injuries, listed from milder to more severe, include:
- Rupture, tearing of the nerves in place
- Avulsion, a tearing of the nerves away from the spine
Brachial plexus injuries are most often seen in newborn babies as a result of birth trauma and injury. Potential complications of pregnancy and childbirth that may increase the risk of developing Klumpke palsy include:
- A difficult vaginal birth that causes pulling and stretching of the nerves
- A baby in a breech or other abnormal position in the birth canal
- Labor induction or abnormalities
- A large birth weight
- Substantial maternal weight gain
- Operative vaginal delivery with improper use of forceps or other delivery tools
- Maternal diabetes
- Previous delivery with this type of complication
- A second stage of labor that lasts more than an hour
It is possible for Klumpke palsy to develop at any age. Other causes of this condition include accidents and traumatic injuries that damage the nerves, as well as tumors around the brachial plexus nerves.
Symptoms and Diagnosis
A baby with Klumpke palsy may exhibit a range of symptoms. Some may be immediately obvious, while in other cases, they are mild enough to go unnoticed initially.
- Limp lower arm, minimal arm and/or hand movement
- Poor reflexes
- Sensory loss
- Stiff joints
- Muscle weakness and atrophy
- Claw hand, tightened hand and fingers
A newborn with Klumpke palsy holds the arm in an unusual way. The palm may be turned upward or outward, while the elbow remains bent. The symptoms range from mild to severe, depending on the extent of nerve damage.
Often, observation of the symptoms is enough for a doctor to diagnose Klumpke palsy. A doctor may use X-rays, an MRI, or another type of imaging scan to look for damage. These tests can confirm the diagnosis, determine the location of the damaged area, and estimate the severity of the injury. Tests of electrical activity and nerve conduction can also confirm that there is nerve damage and help to determine its severity.
Treatment of Klumpke Palsy
If your child is diagnosed with Klumpke palsy, you should be given all the options for treatments. Most cases are caused by stretch injury, and they usually resolve in the first six months. For these milder cases, your doctor will likely recommend you begin with non-surgical interventions.
Newborns can typically begin gentle massage and physical therapy right away. Exercises help improve range of motion, reduce pain, and encourage healing in the nerves. A therapist may also recommend splints to hold the hand, wrist, or arm in proper alignment.
For more severe cases of Klumpke palsy, when the nerve is torn instead of just stretched, a child may need surgery. Treatment is usually conservative, beginning with therapy and progressing to surgical intervention if there is inadequate improvement after three to six months.
Surgery may then be the best option to repair or reconstruct nerves, transfer tendons for better muscle movement, remove scar tissue from damaged nerves, or even graft a new nerve to replace a damaged one entirely.
Most babies recover from Klumpke palsy. However, it is important to note that, compared to nerve damage higher in the arm, those injuries that result in lower arm palsies are less likely to recover spontaneously. In other words, some type of treatment or intervention is usually necessary for a good prognosis. The earlier that treatment begins, the better the expected outcome. Nerve injuries at the more severe end of the spectrum will generally require surgery and may result in lifelong disability.
Taking Legal Action
Sometimes, when a baby is born with brachial plexus injuries, there is no one to blame. But in many cases, a decision or failure to act by a medical professional can be found to be the underlying cause. A nurse, midwife, or doctor may use too much force, use birthing instruments inappropriately, fail to order a C-section in spite of complications, or fail to diagnose or treat complications like diabetes in the mother.
If you believe that your child’s Klumpke palsy and disability could and should have been prevented, you may have a case for taking legal action. A birth injury lawyer can help you determine if medical malpractice occurred and what your chances are for a successful lawsuit. The right lawyer will help you to recover damages that will assist in the hardship of paying for medical and other expenses related to the damage and obtain justice for you and your child.