Which of the following is the most common neonatal injury during dystocia?

The most common neonatal injury during dystocia is a fractured clavicle. During difficult labor or delivery, particularly when the baby's shoulder becomes lodged in the birth canal, excessive force can be applied by the obstetrician to facilitate delivery. This increased traction can lead to a fracture of the clavicle, which is a relatively vulnerable area in neonates.

Fractured ribs can occur as well, but they are less common compared to clavicle fractures in the context of dystocia. Caput succedaneum, which refers to a swelling of the soft tissues of the head due to pressure during delivery, is also common but is not classified as a fracture or injury per se. Lastly, Erb's palsy, characterized by paralysis of the arm due to trauma to the brachial plexus, is a serious injury resulting from excessive pulling during delivery; however, it is less frequent than clavicular fractures overall. Thus, the clavicle is identified as the most frequently injured bone during such challenging deliveries.