Adult traumatic brachial plexus injuries can have devastating effects on upper extremity function. Although neurolysis, nerve repair, and nerve grafting have been used to treat injuries to the plexus, nerve transfer makes use of an undamaged nerve to supply motor input over a relatively short distance to reinnervate a denervated muscle. A review of several recent innovations in nerve transfer surgery for brachial plexus injuries is illustrated with surgical cases performed at this institution.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Narakas A (1981) Brachial plexus surgery. Orthop Clin North Am 12(2):303–323
Kline DG, Tiel RL (2005) Direct plexus repair by grafts supplemented by nerve transfers. Hand Clin 21:55–69
Brophy RH, Wolfe SW (2005) Planning brachial plexus surgery: treatment options and priorities. Hand Clin 21(1):47–54
Bentolila V, Nizard R, Bizot P, et al. (1999) Complete traumatic brachial plexus palsy: Treatment and outcome after repair. J Bone Jt Surg 81-A(1):20–28
Samii M, Carvalho GA, Nikkhah G, et al. (1997) Surgical reconstruction of the musculocutaneous nerve in traumatic brachial plexus injuries. J Neurosurg 87(6):881–886
Chuang DC, Epstein MD, Yeh MC, et al. (1993) Functional restoration of elbow flexion in brachial plexus injuries: Results in 167 patients (excluding obstetric brachial plexus injury). J Hand Surg 18A(2):285–291
Hentz VR, Narakas A (1988) The results of microneurosurgical reconstruction in complete brachial plexus palsy: Assessing outcome and predicting results. Orthop Clin North Am 19(1):107–114
Songcharoen P, Wongtrakul S, Spinner RJ (2005) Brachial plexus injuries in the adult. Nerve transfers: The Siriraj Hospital experience. Hand Clin 21:83–89
Merrell GA, Barrie KA, Katz DL, et al. (2001) Results of nerve transfer techniques for restoration of shoulder and elbow function in the context of a meta-analysis of the English literature. J Hand Surg 26A:303–314
Merrell GA, Wolfe SW (2002) Adult brachial plexus and thoracic outlet surgery. Tech Should Elb Surg 3(4):271–281
Birch R, Bonney G, Wynn Parry CB (1998) Traumatic lesions of the brachial plexus. In: Surgical disorders of the peripheral nerves. Churchill Livingstone, Hong Kong, pp 175–177
Narakas AO, Hentz VR (1988) Neurotization in brachial plexus injuries: Indications and results. Clin Orthop Relat Res 237:43–56
Bertelli JA, Ghizoni MF (2004) Reconstruction of C5 and C6 brachial plexus avulsion injury by multiple nerve transfers: Spinal accessory to suprascapular, ulnar fascicles to biceps branch, and triceps long or lateral head branch to axillary nerve. J Hand Surg [Am] 29(1):131–139
Witoonchart K, Leechavengvongs S, Uerpairojkit C, et al. (2003) Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part I: An anatomic feasibility study. J Hand Surg 28A:628–632
Hallock GG (1993) The triceps muscle flap for axillary contracture release. Ann Plast Surg 30:359–362
Lim AYT, Pereira BP, Kumar, VP (2001) The long head of the triceps brachhii as a free functioning muscle transfer. Plast Reconstr Surg 107:1746–1752
OberlinC, Beal D, Leechavengvongs S, et al. (1994) Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: Anatomical study and report of four cases. J Hand Surg 19A(2):232–237
Nagano A, Tsuyama N, Ochiai N, et al. (1989) Direct nerve crossing with the intercostals nerve to treat avulsion injuries of the brachial plexus. J Hand Surg 14A(6):980–985
Mackinnon SE, Novak CB, Myckatyn TM, et al. (2005) Results of reinnervation of the biceps and brachialis muscles with a double fascicular transfer for elbow flexion. J Hand Surg [Am] 30(5):978–985
Brandt KE, Mackinnon SE (1993) A technique for maximizing biceps recovery in brachial plexus reconstruction. J Hand Surg 18A:726–733
Mackinnon SE, Dellon AL (1991) Surgery of the peripheral nerve. Thieme Medical Publishers, New York, pp 423–454
Chuang DCC, Yeh MC, Wei FC (1992) Intercostal nerve transfer of the musculocutaneous nerve in avulsed brachial plexus injuries—evaluation of 66 patients. J Hand Surg 17A:822–828
Chuang DC (2005) Nerve transfers in adult brachial plexus injuries: My methods. Hand Clin 21:71–82
Leechavengvongs S, Witoonchart K, Uerpairojkit C, et al. (1998) Nerve transfer to biceps muscle using a part of the ulnar nerve in brachial plexus injury (upper arm type): A report of 32 cases. J Hand Surg 23A(4):711–716
Teboul F, Kakkar R, Ameur N, et al. (2004) Transfer of fascicles from the ulnar nerve to the nerve to the biceps in the treatment of upper brachial plexus palsy. J Bone Jt Surg 86-A(7):1485–1490
Sungpet A, Suphachatwong C, Kawinwonggowit V, et al. (2000) Transfer of a single fascicle from the ulnar nerve to the biceps muscle after avulsions of upper roots of the brachial plexus. J Hand Surg 25B(4):325–328
Leechavengvongs S, Witoonchart K, Uerpairojkit C, et al. (2003) Nerve transfer to deltoid muscle using the nerve to the long head of the triceps, part II: A report of 7 cases. J Hand Surg 28A:633–638
Doi K, Sakai K, Kuwata N, et al. (1995) Double-muscle technique for reconstruction of prehension after complete avulsion of brachial plexus. J Hand Surg [Am] 20:408
Barrie KA, Steinmann SP, Shin AY, et al. (2004) Gracilis free muscle transfer for restoration of function after complete brachial plexus avulsion. Neurosurg Focus 16(5):E8
Approval obtained from Hospital for Special Surgery Institutional Review Board
Level IV: series with no or a historical control group.
About this article
Cite this article
Rohde, R.S., Wolfe, S.W. Nerve Transfers for Adult Traumatic Brachial Plexus Palsy (Brachial Plexus Nerve Transfer). HSS Jrnl 3, 77–82 (2007). https://doi.org/10.1007/s11420-006-9027-y
- brachial plexus
- nerve transfer
- nerve repair