In serious erb’s palsy injury cases, surgery is often an important aspect of care.
There are surgeons from different specialities who specialize in these surgeries.
This is from the Boston Children’s Hospital, which is a leading center is treating these injuries:
Nerve surgery, also known as microsurgery, repairs or reconstructs the injured nerves and is recommended if recovery is still inadequate 3 to 6 months after birth. This surgery generally consists of a combination of nerve grafting and nerve transfer procedures. It is best performed between 3 and 9 months of life and is usually not beneficial for children beyond 1 year of age.
Nerve grafting surgery involves removing the injured portion of the nerve and replacing it with nerve grafts. These nerves usually come from the leg (sural nerves).
Nerve transfer surgery redirects nearby nerves from the arm or chest to take over for the damaged nerves.
An osteotomy is a procedure in which bones are cut and reoriented to improve upper extremity function by better positioning the hand and arm. It is most commonly performed on the humerus (upper arm bone) or forearm.
A tendon is the end of a muscle that attaches to the bone.
Tendon transfers involve separating the tendon from its normal attachment and reattaching it to a new location. This procedure, typically performed between age 1 and adulthood, allows a healthy muscle to help a weaker or injured muscle to return to its desired function. Tendon transfers are usually done around the shoulder to improve the ability to raise the arm, but may be done in the forearm, wrist, or hand. Children are often in a cast for four to six weeks after surgery.
Open reduction of the shoulder joint, performed through a surgical incision or using arthroscopy, reduces (placing the humeral head back in joint) and surgically tightens loose tissue around the shoulder joint. The procedure is needed when persistent muscle weakness has caused shoulder joint instability or dislocation. It is often performed in conjunction with other surgical procedures.
A free muscle transfer is an extensive surgery, typically using leg muscles, which required reconnection of blood vessels and nerves under microscope. It is performed only when there are no local muscles in the arm or hand to replace dysfunctional muscles.