When should I consider referring a patient with obstetric brachial plexus injury to a specialist for further management?

Consider referring a patient with obstetric brachial plexus injury to a specialist for further management if:

• There are no signs of nerve recovery 6 weeks after the injury.
• Recovery is not progressing as expected during rehabilitation therapy.
• The patient has a poor prognosis for recovery after rehabilitation therapy and nerve conduction studies.

Referral should be made to a specialist peripheral nerve injury service for assessment and possible surgical intervention.

Early assessment and ongoing monitoring of nerve function and recovery are essential to guide the timing of referral.