Abstract
Nerve Transfers to Restore upper Extremity Function: A Paradigm Shift.
Highlights
Motor function after nerve injury is dependent on both time to reinnervation and the number of motor axons reinnervating the target muscle [3]
Functional outcomes with grafting are similar to those seen with nerve transfers and donor site morbidity from a nerve transfer is avoided
A hierarchy of return of function exists with efforts directed to restoring elbow flexion first, followed by shoulder function, hand function
Summary
Motor function after nerve injury is dependent on both time to reinnervation and the number of motor axons reinnervating the target muscle [3]. The ideal timing of nerve transfers has not yet been established, but reinnervation of the muscle by 12–18 months after injury is a common goal. We use nerve transfers to treat most brachial plexus injuries (avulsions or not) and peripheral nerve injuries in upper arm or proximal forearm.
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