Nerve Transfer Techniques in Injuries of the Upper Limb

Abstract

Proximal nerve injuries of the upper limb or the braquial plexus are associated with a poor prognosis, even with prompt repair. In the last few decades, an increase in nerve transfer techniques has occurred, by which a denervated peripheral nerve is reinnervated by a healthy donor nerve. Nerve transfers are indicated in proximal brachial plexus injuries in which grafting is not possible, or in proximal injuries of peripheral nerves with long reinnervation distances.

Nerve transfers represent a revolution in peripheral nerve surgery, and offer the potential for superior functional recovery in severe nerve injuries. In complete brachial plexus injuries, the existence of nerve roots (intraplexual transfers) is being studied. If they do not exist, the transference of nerves out of the plexus is performed (extraplexual transfers), such as the spinal accessory nerve, the phrenic nerve, the intercostal nerves, etc.

In this update paper, the different motor intra- and extraplexual nerve transfer techniques are reviewed.

Keywords

nerve transfers - brachial plexus - nerve injury

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