Is all brachial plexus injury caused by shoulder dystocia?
Introduction In his 2002 paper, Pecorari states the following: Unfortunately for obstetricians and midwives, in court Erb palsy has been causally connected with shoulder dystocia and errors in management, although it is not always true. Perhaps the lack of an obvious explanation has contributed to the identification of the birth attendant as a handy scapegoat. When there is a permanent brachial plexus injury following shoulder dystocia, responsibility for this injury is often presumed to be with the obstetrician who supposedly did not foresee that a shoulder dystocia was likely to occur or mishandled it when it did. Yet a review of the literature does not substantiate such assumptions. Gherman in his 1998 paper summarizes the refutation to these claims: We feel that some cases of brachial plexus injury are unavoidable events. Recent reports have noted that brachial plexus palsies occur: (1) In the absence of characteristic risk factors (2) In the absence of shoulder dystocia (3) In the
