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

Step 1: Understanding the Question:
We need to find the one statement about obstetric brachial plexus palsy that is FALSE.

Step 2: Key Formula or Approach:
Obstetric brachial plexus palsy happens when the nerves running from the neck to the arm are stretched during a difficult delivery, usually from pulling on the head while the shoulder is stuck (shoulder dystocia) or from traction on the shoulder girdle itself. Knowing which roots are usually hurt, and how the condition is usually managed, tells us which statement does not fit.

Step 3: Detailed Explanation:
The upper roots of the plexus, C5 and C6, are the ones most often stretched, since the head and shoulder are forced apart in opposite directions during delivery. This pattern is called Erb's palsy and is true.
The injury is a stretch or traction injury of the shoulder girdle and neck during birth, so that statement is also true.
Most babies with this palsy, around eight to nine out of ten, recover well with simple conservative treatment, gentle physiotherapy and positioning of the arm, without needing any operation. So good prognosis with conservative management is a true statement.
Surgery is not the first step. Doctors wait and watch, usually for three to six months, and only operate (nerve exploration or grafting) if there is no sign of recovery by then. Operating immediately, before giving the nerve a chance to heal on its own, is not standard practice and does not give better results than waiting.

Step 4: Final Answer:
So the false statement is that there is good progress with immediate surgery, since conservative management is tried first and most cases recover without any operation at all.