Upon completion of the history and physical evaluation an anatomical understanding of the level of injury is established. In addition, utilizing the physical presentation of each patient will help in localizing the injury pattern.
In patients with completely flaccid or hypotonic upper extremities, with complete anesthesia and decreased attention and awareness a complete plexus palsy C5-T1 is diagnosed.
Patients who present with a defect in shoulder movement, elbow extended, forearm pronated and wrist in flexion have an injury pattern located to the upper roots C5-C7 classically termed “Waiter’s Tip” or Erb’s Palsy.
In rare instances, patients will present with intact shoulder and elbow flexion lacking function in their hand. These patients are also associated with higher rates of Horner’s Syndrome. These patients posses injuries to the lower roots C7-T1, classically termed Klumpke’s Palsy.