But what is the cause of an obstetric brachial plexus palsy? Basically, plexus injury is caused by serious accidents in which the nerves in the shoulder joint are massively overstretched and can partially tear. If these injuries happen during birth, it is called obstetric brachial plexus palsy, which results in paralysis of the arm nerves. Brachial plexus birth palsy occurs in approximately one in every thousand births. Risk factors include:

• shoulder dystocia (during birth, the baby's shoulder gets stuck in the mother's pelvis, causing birth arrest)
• macrosomia (birth weight over 4 kg)
• maternal obesity (especially in cases of diabetes mellitus or gestational diabetes)
• foeto-maternal disproportion (disproportion between mother and fetus)
• breech birth

Mild obstetric brachial plexus palsy may heal on its own within a few weeks. If, on the other hand, the nerves are severely overstretched, the result is limited mobility, lack of strength and low sensitivity in the arm.

Everyday things, such as tying shoes, putting on a sweater or cutting bread, can become a challenge for children with plexus palsy.

Typical symptoms of obstetric brachial plexus palsy are:

• malpositions at the shoulder (internal rotation malposition)
• malpositions at the elbow/forearm (supination or pronation malposition of the forearm)
• a drop hand (flaccid drooping of the hand)
• a collapsed thumb.

Physiotherapeutic, orthopedic and surgical therapy options exist for each individual or combination of these movement changes and maldevelopments.

Orthotic treatment is recommended for rest periods - especially nighttime bed rest. An orthosis includes static and dynamic positioning elements, promotes joint correction and counteracts muscle imbalance as best as possible, among other things.