Four of seven patients achieved ≥M3 shoulder abduction with a single nerve transfer and 6 of 7 regained ≥M3 strength with a dual nerve transfer.
Nerve transfer surgery to restore upper extremity function in cervical spinal cord injury (SCI) is novel and may transform treatment.
We conclude that nerve transfer is an effective means to restore elbow and shoulder function in brachial plexus paralysis.
We report the results of 15 patients who underwent nerve transfer for restoration of shoulder and elbow function at our institution for traumatic brachial plexus palsy.
Although previous studies have revealed high success rates (70%to85%5%) after an intradural somatic-to-autonomic nerve transfer procedure in children with spinal dysraphism, no study has had a control group or blinded observers.
In patients with a recovering proximal ulnar nerve injury, a SETS nerve transfer conceptually is useful to protect and preserve distal motor end plates until the native axons fully regenerate.
We describe our technique for a SETS nerve transfer of the terminal anterior interosseous nerve (AIN) to the pronator quadratus muscle (PQ) end-to-side to the deep motor fascicle of the ulnar nerve in the distal forearm.
In addition, for nerve injuries in which incomplete regeneration is anticipated, a SETS nerve transfer may be useful to augment the regenerating nerve with additional axons and to more quickly reinnervate target muscle.
Current surgical methods to treat short or long-gap injuries including autographs, nerve transfer, and nerve conduits, and limitations motivating on-going research to further promote repair by the inclusion of novel conduits, controlled-release growth permissive factors, cell transplantation, and application of biophysical stimuli such as exogenous electrical stimulation are described.
Given the prior experimental evidence, and the prior clinical data from patients with carpal tunnel syndrome and digital nerve repair, the implication of this new work is to consider a well designed clinical trial for use of brief ES in nerve graft and nerve transfer repairs.
Although the AIN to ulnar motor group SETS nerve transfer was specifically designed for ulnar nerve injuries, we believe that the SETS procedure might have broad clinical utility for second- and third-degree axonotmetic nerve injuries, to augment partial recovery and/or "babysit" motor end plates until the native parent axons regenerate to target.
