Erb’s Palsy
A 1-day-old new-born girl is brought to the paediatric clinic by her parents, who are concerned about the lack of movement in her right arm since birth. The baby was delivered vaginally after a prolonged and difficult labour. The mother recalls that the baby’s shoulder got stuck during delivery, requiring assistance to be born. Since birth, the baby has been unable to move her right arm, and the arm hangs limp by her side with the palm facing backward.
On physical examination, the right arm shows weakness with absent movement at the shoulder and elbow. The wrist and hand movements are intact. The Moro reflex is absent on the right side, and the arm is positioned in "waiter's tip" posture. Based on the history and examination, the paediatrician diagnoses the infant with Erb’s Palsy, caused by a brachial plexus injury during delivery.
The treatment plan includes physical therapy to encourage arm movement and prevent joint stiffness. The parents are reassured that many cases improve with time, though close follow-up will be needed to monitor progress. If there is no improvement within a few months, further interventions such as nerve studies or surgical options may be considered.
a). Premature birth
b). Use of forceps
c). Shoulder dystocia during a prolonged labour
d). Caesarean section
a). "Waiter’s tip" posture of the arm
b). Swollen joints
c). Full range of movement in both arms
d). Clubfoot
a). Babinski reflex
b). Moro reflex
c). Patellar reflex
d). Rooting reflex
a). Immediate surgery
b). Corticosteroid injections
c). Physical therapy and monitoring
d). Immobilization of the arm for 6 months
