Anomalous reinnervation as a sequel to obstetric brachial plexus palsy

In 3 patients with sequelae of brachial plexus birth injury we observed associated movements and also synchronous motor unit potentials and motor axo-axonic reflexes between different muscles, sometimes with antagonist function. To explain these synkineses is necessary to assume that there is simultaneous innervation by the same motoneurone of 2 or more "motor subunits" in different muscles. Therefore we suggest that the motoneurone branches originate proximally from the primary trunk of the brachial plexus. Careful clinical and neurophysiological study can show these complex simultaneous innervations and also suggest correct kinesiotherapy.

Infantile Erb's palsy (Smellie's palsy)

Our experience with 32 infants seen with Erb's palsy, of whom 11 were followed as long as 18 years, suggests two management axioms. First, it is probably harmful to the infant to use airplane splints. Seocnd, passive stretching of the tight scapulohumeral adductors and passive normal range of motion exercises to shoulder and elbow will usually give a successful outcome in this obstetrical complication. Finally, even though the shoulder muscles regain their strenght, the "Erb engram" may remain as a mark of Erb's palsy.