P BRACHIAL PALSY X BIRTH INJURY PATHWAY

The Toronto Test Score*

Elbow flexion	0–2
Elbow extension	0–2
Wrist extension	0–2
Digital extension	0–2
Thumb extension	0–2
Total score	0–10

Each of the listed motor functions is tested and allocated a numeric value. A score of 0 denotes no function and a score of 2 denotes full or normal function.

Key Points • 

There should be a low threshold for an x-ray (clavicle and upper arm) in all infants with an apparent brachial plexus injury •

 Associations of a brachial nerve palsy include fracture of the clavicle1 , phrenic nerve palsy2 and Horner’s syndrome •

 Respiratory distress associated with an Erb’s palsy will require a chest x-ray. • 

The physiotherapists will document the results of the Toronto movement assessment scale at 8 weeks and 12 weeks3 •

 An infant with a result of <3.5 on the Toronto scale should be considered for referral for surgery at a specialist centre4


REFL TO STANMORE