File:Diseases of children (1916) (14579492500).jpg

Identifier: diseasesofchildr00grah (find matches)
Title: Diseases of children
Year: 1916 (1910s)
Authors: Graham, Edwin Eldon, b. 1864
Subjects: Children Disease
Publisher: Philadelphia and New York, Lea & Febiger
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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e, and theshoulder blades become prominent. Thebones of the arm fail to grow normally,and subluxation of the shoulder whichtends still further to interfere with motion may develop. A fracture of the clavicle or humerus, or a separationof the epiphysis of the upper end of the humerus, is a complicationwhich is occasionally found at birth and renders the diagnosis andprognosis of Erbs palsy more difficult. Diagnosis.—An old case of Erbs palsy, seen for the first time, maysimulate anterior poliomyelitis. Erbs palsy develops at birth or soonafter, and infantile paralysis always at a considerable period afterbirth. Subluxation of the shoulder is suggestive of Erbs palsy,and the group of muscles affected in Erbs palsy is not often foundaffected in infantile paralysis. Paralysis due to syphilis can be differ-entiated by the history and other evidences of syphilis. The inwardrotation of the arm resulting from a separation of the upper epiphysisof the shoulder can he diagnosed by the x-rays.
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Fig. IS.^Erbs palsy. 110 DISEASES OF THE NEWBORN Prognosis.—^The fewer the muscles involved and the earlier thetreatment is begun, the better the prognosis. Most cases recoverentirely, although a few in spite of treatment show little or noimprovement. Treatment.—If the muscles respond to faradism rapid recoveryoften results, and the affected muscles should be treated with faradismevery day, provided they respond; if they do not respond, galvanismshould be employed. Dail)^ massage will improve the nutrition of theparts, and tends to prevent the development of contractures. Forthose patients who have been treated faithfully and systematicallyby massage and electricity for some months without benefit, a plasticoperation on the injured nerves and tendons is worthy of consideration;in a few cases, quite satisfactory results have followed the suturingof the involved nerve trunks. -FROM FOURTH CERVICAL TO SCALENI &LONGUS COLLI

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