Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


The _upper-arm type_--Erb-Duchenne paralysis--is that most frequently
met with, and it is due to a lesion of the fifth anterior branch, or, it
may be, also of the sixth. The position of the upper limb is typical:
the arm and forearm hang close to the side, with the forearm extended
and pronated; the deltoid, spinati, biceps, brachialis, and supinators
are paralysed, and in some cases the radial extensors of the wrist and
the pronator teres are also affected. The patient is unable to supinate
the forearm or to abduct the arm, and in most cases to flex the forearm.
He may, however, regain some power of flexing the forearm when it is
fully pronated, the extensors of the wrist becoming feeble flexors of
the elbow. There is, as a rule, no loss of sensibility, but complaint
may be made of tickling and of pins-and-needles over the lateral aspect
of the arm. The abnormal position of the limb may persist although the
muscles regain the power of voluntary movement, and as the condition
frequently follows a fall on the shoulder, great care is necessary in
diagnosis, as the condition is apt to be attributed to an injury to the
axillary (circumflex) nerve.

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