455 Distal Nerve Transfers in Treatment of Peripheral Nerve Lesions

Abstract

INTRODUCTION: Distal nerve transfers can be used in treating patients with irreparable high nerve lesions, aiming to regain hand function. The indications for these transfers include upper (C5-C6) and lower (C8-T1) brachial plexus palsy, isolated proximal extensive radial, median, or ulnar nerve lesion, or isolated axillary or musculocutaneous nerve lesion. METHODS: The selected cases (n = 5) included lower brachial plexus injury (n = 2), and isolated radial (n = 1), ulnar (n = 1), and median (n = 1) nerve injuries. The MRC grading was used to examine postoperative muscle strength. The DASH and PNSQoL questionnaires were used to assess the postoperative quality of life. RESULTS: The useful functional recovery (MRC = 4-5) was achieved in all presented cases. The DASH and PNSQoL scores indicated a satisfying quality of life in terms of the absence of postoperative disability. CONCLUSIONS: Distal nerve transfers are a valuable technique for treatment of the patients with irreparable proximal nerve lesions. This technique reduces the path necessary for the regenerative nerve fibers to pass, provides direct nerve coaptation without additional suture line, and facilitates faster and better recovery, with the final outcome as an increase in the patients’ quality of life.