That’s a Big Baby, Pawpaw!

According to the Guinness Book of World Records, the biggest baby ever born weighed 23 pounds, 12 ounces. The average weight of a newborn is only 7 pounds, 8 ounces. So, are their health risks when a woman gives birth to a baby almost 3 times the typical size of newborn? The answer is yes. In today’s day and age, many women opt for a c-section over a natural birth. Of course, there are advantages and disadvantages to both options. One of the risks of having a larger than normal child naturally is a condition known as a brachial plexus injury.

A brachial plexus injury (BPI) can occur when the child’s shoulder gets caught in the birth canal causing an injury to the brachial plexus. What is the brachial plexus you ask? It is a nexus of nerves originating from spine roots C5-T1 that innervate the entire upper extremity. According to the Mayo clinic, the most common causes of BPI besides birth injuries are sports injuries (e.g. stingers), trauma (e.g., car accidents), and cancer related treatments or tumors. A BPI can lead to severe functional limitations such as numbness, muscle atrophy, pain, joint stiffness, and/or permanent disability. When the muscles do not get input from the nervous system, then the muscles cannot move. Over time, they can completely atrophy due to no innervation. The nerves also provide sensory input as well. So, depending upon what part of the brachial plexus is affected, the resulting disability can vary greatly.

Treatment for BPI depends upon the extent of the injury. In some cases, the nerves can heal themselves over time without surgical intervention. Therapy is typically prescribed to address weakness and range of motion for increased functional use of the affected limb. In other cases, the surgeon needs to repair the nerves at the level of the brachial plexus or spine. Another common surgical intervention in the DFW area for children with BPI is a tendon transfer to help the patient regain a specific functional motion, such as elbow flexion. In both surgical cases, therapy again plays an integral part in helping the patient regain functional use of the affected extremity.

Fortunately, injuries to the brachial plexus are not overly common. The incidence rate of birth related BPI is between 0.15 and 3 per 1000 births. One of our owners, David Myers, has worked in the brachial plexus clinic at Children’s Medical Center Dallas. These injuries are challenging and require specialized care from physician to therapist. We are here to help patients with BPI or any injury that affects the upper extremity Monday through Friday. We hope no one ever has to go through a BPI, but having the right people at the right time is always a good thing.


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