Distal Nerve Transfers for the Upper Extremity: A Review

Abstract

Introduction Injuries to the peripheral nerves have troubled surgeons since time immemorial. Repair of the nerves, either primarily or using grafts, has been the method of treatment of nerve injuries. Nerve transfers revolutionized the results by bringing the coaptation closer to the target receptor, hence improving results. There is constant refinement, with newer, innovative nerve transfers which can be used for even more specific function. The concept of collateral sprouting has allowed specific targeted transfers, with minimal loss of the donor function.

Materials and Methods This was a review of novel distal nerve transfers for the upper extremity. The indications include high-nerve injuries, brachial plexus injuries, and spinal cord injuries. These transfers include novel transfers around the elbow as well as transfers in the forearm and hand.

Discussion These transfers aim to improve the recovery of patients with proximal nerve injuries, minimizing donor site morbidity at the same time. However, the use of these procedures is not yet widespread, with the jury still out regarding the efficacy of these procedures.