Adolf stoffel and the development of peripheral neurosurgical reconstruction for the management of paralysis: One hundred years of nerve transfer surgery

Abstract

The concept of nerve transfer as an alternative solution for paralysis through rewiring a denervated motor nerve using an intact and expendable nerve branch or fascicle in proximity to the injured nerve became widely adopted as a strategy for nerve root avulsion in brachial plexus injuries. The success of the technique has encouraged clinicians to extend the indications for other complex nerve injuries, and the technique may be considered as an adjunct or replacement to nerve grafting for some proximal, high-energy, and late-presenting peripheral nerve injuries. The technique is not new. Many of the current “advances” in peripheral nerve transfer were described contemporaneously by Adolf Stoffel in 1911. He was an orthopedic surgeon working in Germany in the early 1900s. He had an interest in nerve injury reconstruction, described the functional fascicular anatomy of the peripheral nerves, developed an intraoperative nerve stimulator, and pioneered many of the techniques used today. His work was never translated from the German language and did not, therefore, receive wide acknowledgment. The aim of this study is to correct the perceived timeline of nerve transfer surgery and include the pioneering work of Adolf Stoffel.