When should I consider referring a patient with obstetric brachial ple

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

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.

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