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Review Question - QID 2263

QID 2263 (Type "2263" in App Search)
You’re asked to evaluate a 7-day-old infant in the NICU for decreased movement of his right upper extremity since birth. On chart review, you see that he is 97th percentile for head circumference, 84th percentile for height, and 88th percentile for weight, and underwent a prolonged vaginal delivery. On exam, the right upper extremity is adducted with internal rotation of the shoulder, extension of the elbow and pronation of the forearm. Which of the following factors has a poor prognosis for spontaneous recovery?