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Erb Palsy — RACP Paediatrics MCQ

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EasyNeonatologyErb PalsyRACP Paediatrics

A term newborn has poor Moro reflex on the right side with the right arm held in adduction and internal rotation with extended elbow and pronated forearm. There is intact hand grip. Labour was complicated by shoulder dystocia. What nerve roots are affected?

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Correct answer: D — C5–C6 (Erb palsy)

Erb palsy (C5–C6 upper brachial plexus injury) presents with the 'waiter's tip' posture: adducted and internally rotated shoulder, extended and pronated forearm, with preserved hand grip. It is the most common birth-related brachial plexus injury, typically associated with shoulder dystocia, macrosomia, or instrumental delivery. Most cases resolve within 3–6 months.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Birth Injuries