Anatomy · Upper Limb

Klumpke palsy

2 min read

  • Klumpke's paralysis (Klumpke palsy): lower brachial plexus injury involving the C8 and T1 nerve roots, sometimes C7.

Cause

  • Caused by hyperabduction of the arm: a fall on an outstretched hand, the arm pulled into machinery, or a breech delivery with the arm extended.

Claw Hand

  • Claw hand: from paralysis of the flexors of the wrist and fingers (C6 to C8) and all intrinsic muscles of the hand (C8, T1).

Sensory Loss and Horner's Syndrome

  • Sensory loss along the medial border of the forearm and hand (T1).
  • Horner's syndrome: partial ptosis, miosis, anhydrosis and enophthalmos, from involvement of sympathetic fibres to the head and neck leaving the spinal cord via T1.
  • Horner's syndrome occurs only if T1 is injured proximal to the white ramus communicans to the first thoracic sympathetic ganglion.