Question

Which one of the following is NOT true regarding obstetric brachial plexus palsy?

• A. Upper roots are mostly affected
• B. Results from traction on shoulder girdle
• C. Good progress with immediate surgery
• D. Good prognosis with conservative management

Hint:

Remember most obstetric brachial plexus palsy cases are watched and treated conservatively first.

Answer 1

The Correct Option is C

This question is about obstetric brachial plexus palsy and asks which statement about it is false. Let's work through each one.

1. Upper roots are mostly affected: True. The C5 and C6 roots are stretched the most when the head and shoulder are pulled apart during a hard delivery, giving the typical Erb's palsy pattern.
2. Results from traction on shoulder girdle: True. The injury is a stretch injury of the neck and shoulder girdle nerves during birth, often linked with shoulder dystocia.
3. Good progress with immediate surgery: False. Doctors do not operate right away. They wait and watch for around three to six months with gentle physiotherapy, since most babies recover well on their own. Surgery is kept in reserve for the small number who show no recovery by then, not offered immediately.
4. Good prognosis with conservative management: True. Most infants, around eight to nine in ten, recover well with simple conservative care alone.

The one statement that does not hold up is the claim about immediate surgery giving good progress, since conservative treatment comes first and works for the large majority of babies.

Let's summarize:

• Obstetric brachial plexus palsy mostly affects the upper roots from traction during delivery.
• Most cases recover with conservative management, not immediate surgery.

So the false statement is that there is good progress with immediate surgery.