For Referring Physicians & Therapists
A subspecialty partner for your most complex patients.
Pediatricians, neonatologists, obstetricians, neurologists, physiatrists, orthopaedic surgeons, geneticists, and hand therapists across Florida — and beyond — trust Dr. Irwin with patients who need expertise that's hard to find. Every referring clinician receives a direct report back, and your patient returns to you for ongoing care.
Callback within 24–48 hours. New patients typically seen within 7–10 days. Urgent newborn brachial plexus concerns are prioritized and seen sooner — call directly rather than waiting on a form.
Refer or ask: 844-407-4070 · Fax records: 407-743-3050
One-page referral guide
When to refer, what's urgent, what to send, and what comes back to you — sized for a clinic wall or a chart pocket.
Where to send records
Fax: 407-743-3050
Or mail to Rothman Orthopaedics — Innovation Tower, 265 E. Rollins Street, Suite 11100, Orlando, FL 32804. Please include the referring provider's name and callback number.
Helpful: clinic notes, imaging with reports, EMG/nerve studies, therapy notes. Incomplete records should never delay a referral.
For hand therapists & OT/PT
Post-operative protocols, splinting guidance, and therapy-after-nerve-surgery references live in the Resources area. Call the office for the access code — therapy teams caring for shared patients are given it on request.
Evaluations and progress notes can be faxed to 407-743-3050. Protocol questions and phase-advancement calls are welcome before advancing a patient, not after.
What you receive back
- Dr. Irwin's findings and plan after the visit
- Direct surgeon-to-surgeon or surgeon-to-therapist contact when it's useful
- Your patient back in your care for everything outside the hand and upper extremity
Procedures & Capabilities
What can be offered here
Organized for a quick scan when you're deciding where a patient belongs.
Brachial plexus
- Microsurgical nerve reconstruction — grafting and nerve transfers
- Neurolysis and exploration
- Secondary reconstruction: tendon transfers, shoulder rebalancing
- Traumatic plexus injury in older children and adolescents
Spasticity & cerebral palsy
- Selective neurectomy
- Tendon transfers and tendon lengthening
- Nerve transfers, including after spinal cord injury
- Thumb-in-palm and wrist position reconstruction
- Goal-directed upper limb planning with therapy teams
Congenital differences
- Syndactyly release, with grafting as needed
- Polydactyly and thumb duplication reconstruction
- Thumb hypoplasia reconstruction and pollicization
- Radial and ulnar deficiency
- Constriction ring, camptodactyly, clinodactyly, arthrogryposis
Reconstructive microsurgery
- Replantation and revascularization
- Free tissue transfer and limb salvage
- Nerve repair, grafting, and transfer
- Lymphedema surgery
- Vascular malformations and upper limb masses
Trauma & complex fractures
- Acute hand, wrist, forearm, and elbow fracture care
- Growth plate injuries
- Malunion and nonunion reconstruction
- Post-traumatic deformity correction
- Wrist arthroscopy and complex wrist conditions
Adults, as well as children
- Adults living with the long-term effects of brachial plexus birth injury, cerebral palsy, or a congenital difference
- Adult nerve injury and nerve reconstruction
- Complex hand and wrist problems, including revision and post-traumatic reconstruction
- Microsurgical reconstruction across the age range
Not sure it fits?
Call anyway. If it isn't the right practice for your patient, you'll get a straight answer and, where possible, a name of someone better suited — usually the same day.
844-407-4070Time-sensitive: brachial plexus birth injuries
Early evaluation changes outcomes. Infants with a brachial plexus birth injury benefit from specialist assessment within the first weeks of life. The window for primary nerve reconstruction is finite — early referral preserves every option, even when observation ends up being the right plan. When in doubt, refer; no injury is too mild or too early to evaluate.
Cerebral palsy & spasticity: there is no "too late"
Many families are never told that surgery can improve hand and arm function in cerebral palsy. Goal-directed nerve and tendon procedures can reduce spasticity, improve position and grasp, and ease hygiene and caregiving — at nearly any age. Dr. Irwin partners closely with neurology, physiatry, and therapy teams to select the right candidates and the right goals.
Also consider referral for
Congenital hand differences (ideally in infancy, so families can plan timing together) · failed or incomplete recovery after nerve injury · complex fractures and growth plate injuries · tumors and vascular malformations of the upper limb · any pediatric hand problem where you'd value a subspecialist's opinion.
How to refer
- Call the office. You’ll hear back within 24–48 hours, and new patients are typically seen within 7–10 days. Urgent newborn plexus consultations are prioritized and seen sooner.
- Send records. Clinic notes, relevant imaging, EMG/nerve studies, and therapy notes if available. Incomplete records should never delay a referral.
- Receive a report. You'll get Dr. Irwin's findings and plan, and shared patients return to your care for everything else.
Out-of-state and international physicians: record reviews and remote second opinions can be arranged for families considering travel to Orlando. Start here.
Education & Outreach
Request a talk for your group
Dr. Irwin regularly teaches referring clinicians and therapy teams across Florida. There's no cost — travel within Central Florida is routine, and virtual sessions work well for distant groups.
Grand rounds & trainee teaching
Departmental grand rounds, resident and fellow didactics, and case conferences in pediatrics, orthopaedics, plastic surgery, neurology, and PM&R.
Therapist in-services
Hands-on sessions for occupational and physical therapy teams — post-operative protocols, splinting, therapy after nerve surgery and tendon transfers, and when to call the surgeon.
Primary care & pediatric groups
Practice-meeting or lunch talks for pediatric and family medicine groups: what to watch for, what's urgent, and how to counsel families in the first conversation.
- Brachial plexus birth injury: recognition, timing, and what actually changes outcomes
- The hand and arm in cerebral palsy: what surgery can and cannot do
- Congenital hand differences: what to tell families in the first week
- Pediatric fractures around the growth plate: pitfalls and referral triggers
- Nerve transfers in children: how they work and who benefits