“Waiter’s tip” (Erb’s) palsy: a case report and literature review

Abstract

As primary health care clinicians, chiropractors are increasingly providing the initial assessment of many diverse musculoskeletal conditions. As a consequence, occasionally chiropractors are consulted to assess rare neuromusculoskeletal disorders. A 12-year-old girl was brought in by her mother for a second opinion on the present status of her daughter’s Erb-Duchenne palsy (Erb’s palsy), a diagnosis given at birth. Erb’s palsy is a birth-induced upper brachial plexus injury that, if unresolved, is known to lead to permanent developmental shoulder and elbow articular deformities. These deformities can result in severe restrictions in the proper function of the involved upper limb. The exact pathogenesis is unclear and therefore certain theories are presented. It would appear that early detection of these functional restrictions and the restoration of normal joint function, through active and passive mobilisation during childhood, are an important factor in limiting the extent of these disabilities.