Challenge of the Week / Pediatrics / 06.26.20

Which of the following describes the cookie test for neonatal brachial plexus palsy?
  • The arm should be held abducted to evaluate biceps function with gravity eliminated.
  • The cookie test involves antigravity elbow flexion.

  • The child “passes” the test if he or she is able to get the cookie to the mouth without flexing the neck >45°.
  • This is the correct description of the cookie test.

  • Failure to pass the test by 24 months should prompt consideration for microsurgical plexus exploration.
  • This test should be employed earlier, at age 4 to 6 months, to factor in to operative decision-making.

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