Erb's Palsy and Ptosis on Newborn Examination after Delivery



Two issues here related to shoulder dystocia with difficult extraction:

1) Brachial plexus injury (C5-6) level / Erb’s palsy. 

 - Elbow extended, forearm pronated

 - Upper arm adducted & internally rotated

2) Ptosis from Horner’s syndrome

 - Disruption of sympathetic pathway from superior cervical ganglia involvement

 - More common in Klumpke palsy



Dr Michael Narvey @NICU_Musings



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