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Erbs Palsy

Welcome to the website for Obstetrical Brachial Plexus Palsy Injuries at the Ä¢¹½tvÊÓƵ. We hope you are able to find all of the information you require. If you require any further assistance please do not hesitate to contact us.

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Our Erbs Palsy unit is a renowned leading regional and national multi-disciplinary service which has been managing children and their families with these injuries for over 25 years.

We have successfully cared for a large number of children into their adulthood. This has given us valuable experience and expertise so that we are now currently one of only a few centres in this country that have the facilities and skilled staff to manage nerve injuries comprehensively.

Our overall aim is to deliver excellent multi-disciplinary patient and family centred care to ensure each child achieves the best outcomes after their injury. This encompasses the values of The Ä¢¹½tvÊÓƵ Way.

What we do

After referral to our unit we will aim to give you an appointment to attend one of our practitioner or consultant clinics. This will be when your child is 12 weeks of age or if they are referred after this time then as soon as we can. They will undertake a comprehensive assessment asking you questions regarding your pregnancy, delivery and movement of your child’s arm before physically examining them. Following assessment we will discuss with you a treatment plan for your child. This may include surgery (operating on them to repair their nerves) or non-operative management with physiotherapy and occupational therapy.

We will routinely review them in our Children’s Hand Clinic to assess how they are progressing and to assist in optimising their recovery through advice, surgery or rehabilitation. These reviews often continue throughout their childhood years until adulthood.

Your Condition and Treatment

Once we have received a referral for your child we will aim to offer you an appointment when your child is 12 weeks of age. During this appointment you may meet several members of our MDT (multi-disciplinary team). We will ask you questions regarding your pregnancy, delivery and what movements you have noticed occurring in their affected arm.

We will examine your child including observing the movements of their affected arm. Following the assessment a treatment plan for your child will be formulated and discussed with you. This may include specific exercises and/or surgery to repair the damaged nerves.

If you child is referred after 12 weeks of age we will offer you the next available appointment to attend an outpatient clinic. In clinic you will meet the MDT and undertake a similar assessment. Depending on your child’s age we will also assess their function.

Primary Surgery

If your child requires primary nerve surgery we will aim to do this before they are 6 months of age. They will be given a date for surgery and admitted to the children’s ward. One parent will be allowed to stay overnight with their child whilst they are in hospital.

All surgery is performed under a general anaesthetic and the surgeon will initially examine the nerves to establish the extent of damage. If the nerve is found to be damaged then this part is removed and replaced with a healthy nerve taken from the back of your child’s legs or arm (which is less important) to bridge the gap.


If the nerves have been avulsed (pulled out) from the spinal cord, then nerves from adjacent areas (which do less important jobs) inside and around the plexus will be transferred to aid function to the arm.

After surgery your child’s arm (and legs if grafted) will be bandaged. The arm bandage will also limit any movement of their arm to protect the repair of the nerves. Your child will usually be allowed home after a few days but it is important that the arm bandage stays in place until your next hospital appointment.

You will return to an outpatient dressing appointment 4 to 6 weeks after surgery to remove the bandages and re-start exercises. This may be face to face in clinic or via a video consultation.


The nerve grafts or nerve transfers will all take many months or even over a year before they start to show signs of recovery.

Secondary Surgery

Sometimes it is necessary to perform surgery when your child is a little bit older. This may include releasing tight muscles (subscapularis release) or to help weaker muscles by means of muscle or tendon transfers. We will discuss with you and your child at each stage the reasons why this maybe considered and the benefits this could offer.

The physiotherapy team will initially assess your child’s arm and discuss with you their findings. We will use a combination of exercises to maintain their joint movement and to strengthen their muscles. We will instruct you in how to perform these exercises as part of a home exercise regimen. Providing information on their injury, treatment and the rehabilitation process is also an important part of the therapy sessions.

You will be continually monitored either in the consultant outpatient clinics or with regular physiotherapy appointments. The overall aim at all stages is to help your child with their recovery and to improve the movement, strength and function of their arm based on their individual needs.

The birth of a baby with OBPP can be a traumatic and distressing time and you may go through a range of emotional reactions. In time, your child may also need to adjust to the effects of their injury. The psychologists in the team are used to seeing families in this situation and understand that it takes time to adjust.

You may see the clinical psychologists when you attend the outpatient clinic, on the ward or as an outpatient within their department.

If you feel that yourself or your child would benefit from this service please speak to any member of the team.

Occupational therapy (OT) will aim to promote the maximum level of functional independence for your child. The OT will assess your child’s functional abilities and any difficulties they have in daily and school life. They may also provide your child with a splint to support or gain the best possible function of their arm.

If you live outside of the Ä¢¹½tvÊÓƵ area they will liaise with your local teams and review you regularly when you attend your consultant clinics.

How to find us

The Obstetric Brachial Plexus Palsy Unit is based at Clarendon Wing, Ä¢¹½tvÊÓƵ General Infirmary.

Our outpatient clinics are held on ‘C’ Floor in Martin Wing, Children’s Outpatient Department, Ä¢¹½tvÊÓƵ General Infirmary, on Tuesday afternoons. Please note that although we strive to see every child and their family on time, due to the complexity of our patients, sometimes these clinics may run later than planned.

If your child requires surgery they will be admitted to the Children’s Surgical Admissions Lounge (CSAL) which is located on ‘D’ Floor, Clarendon Wing. Following surgery, your child will be admitted onto ward L41, ‘D’ Floor, Clarendon Wing, where a parent is allowed to stay with them overnight.

If you have already been referred and have a query about your appointment please contact between 8am to 4pm:

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