Distal nerve transfer for thenar palsy: A cadaveric study

Peripheral nerve injuries can result in devastating numbness and paralysis. Surgical repair strategies have historically focused on restoring the original anatomy with interposition grafts. Distal nerve transfers are becoming a more common strategy in the repair of nerve deficits as these interventions can restore function in months as opposed to more than a year with nerve grafts. The changes that take place over time in the cell body, distal nerve, and target organ after axotomy can compromise the results of traditional graft placement and may at times be better addressed with the use of distal nerve transfers. A carefully devised nerve transfer offers restoration of function with minimal (if any) detectable deficits at the donor site. A new understanding of cortical plasticity along with patient reeducation allow for good return of strength and function after nerve transfer.

Download Full-text

Cubital tunnel syndrome

EFORT Open Reviews ◽

10.1302/2058-5241.6.200129 ◽

2021 ◽

Vol 6 (9) ◽

pp. 743-750

Author(s):

Abdus S. Burahee ◽

Andrew D. Sanders ◽

Colin Shirley ◽

Dominic M. Power

Keyword(s):

Ulnar Nerve ◽

Motor Nerve ◽

Nerve Transfer ◽

Cubital Tunnel Syndrome ◽

Cubital Tunnel ◽

Common Procedure ◽

Tunnel Syndrome ◽

Distal Nerve ◽

Denervated Muscles ◽

Simple Decompression

Cubital tunnel syndrome (CuTS) is the second most common compression neuropathy of the upper limb, presenting with disturbance of ulnar nerve sensory and motor function. The ulnar nerve may be dynamically compressed during movement, statically compressed due to reduction in tunnel volume or compliance, and tension forces may cause ischaemia or render the nerve susceptible to subluxation, further causing local swelling, compression inflammation and fibrosis. Superiority of one surgical technique for the management of CuTS has not been demonstrated. Different techniques are selected for different clinical situations with simple decompression being the most common procedure due to its efficacy and low complication rate. Adjunctive distal nerve transfer for denervated muscles using an expendable motor nerve to restore the axon population in the distal nerve is in its infancy but may provide a solution for severe intrinsic weakness or paralysis. Cite this article: EFORT Open Rev 2021;6:743-750. DOI: 10.1302/2058-5241.6.200129

Download Full-text

Obturator to tibial nerve transfer via saphenous nerve graft for treatment of sacral plexus root avulsions: A cadaveric study

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2019.11.021 ◽

2020 ◽

Vol 106 (2) ◽

pp. 291-295 ◽

Cited By ~ 1

Author(s):

Hamid Namazi ◽

Masood Kiani ◽

Saeed Gholamzadeh ◽

Amirreza Dehghanian ◽

Dehghani Nazhvani Fatemeh

Keyword(s):

Tibial Nerve ◽

Nerve Transfer ◽

Nerve Graft ◽

Saphenous Nerve ◽

Cadaveric Study ◽

Sacral Plexus

Download Full-text

Contralateral cervical seventh nerve transfer for spastic arm paralysis via a modified prespinal route: a cadaveric study

Acta Neurochirurgica ◽

10.1007/s00701-019-04069-y ◽

2019 ◽

Vol 162 (1) ◽

pp. 141-146

Author(s):

PeiYang Li ◽

Yundong Shen ◽

Jing Xu ◽

Chunmin Liang ◽

Su Jiang ◽

...

Keyword(s):

Nerve Transfer ◽

Cadaveric Study ◽

Seventh Nerve

Download Full-text

Median to Radial Nerve Transfer to Restore Wrist and Finger Extension: Technical Nuances

Operative Neurosurgery ◽

10.1227/01.neu.0000354364.13224.c8 ◽

2010 ◽

Vol 66 (suppl_1) ◽

pp. ons-75-ons-83 ◽

Cited By ~ 11

Author(s):

Justin M. Brown ◽

Thomas H.H. Tung ◽

Susan E. Mackinnon

Keyword(s):

Radial Nerve ◽

Nerve Palsy ◽

Nerve Transfer ◽

Radial Nerve Palsy ◽

Tendon Transfers ◽

Line Drawings ◽

Nerve Transfers ◽

Finger Extension ◽

Reconstructive Option ◽

Distal Nerve

Abstract Background: Traditional methods for restoring finger and wrist extension following radial nerve palsy include interposition nerve grafting or tendon transfers. We have described the utilization of distal nerve transfers for the restoration of radial nerve function in the forearm. Objective: We review the neuroanatomy of the forearm and outline the steps required for the implementation of this transfer. Methods And Results: We use a step-by-step procedural outline and detailed photographs, line drawings, and video to describe the procedure. Conclusion: This approach is technically feasible and is a reconstructive option for patients with this nerve deficit.

Download Full-text

Restoration of Elbow Flexion in Traumatic Upper Brachial Plexus Palsy in Adults: Outcome with Intraplexus Distal Nerve Transfers in 78 Patients

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0038-1676533 ◽

2018 ◽

Vol 37 (04) ◽

pp. 285-290

Author(s):

Mario Siqueira ◽

Roberto Martins ◽

Wilson Faglioni Junior ◽

Luciano Foroni ◽

Carlos Heise

Keyword(s):

Brachial Plexus ◽

Median Nerve ◽

Ulnar Nerve ◽

Traumatic Injury ◽

Surgical Techniques ◽

Nerve Transfer ◽

Elbow Flexion ◽

Nerve Transfers ◽

Significant Difference ◽

Distal Nerve

Objective To present the functional outcomes of distal nerve transfer techniques for restoration of elbow flexion after upper brachial plexus injury. Method The files of 78 adult patients with C5, C6, ± C7 lesions were reviewed. The attempt to restore elbow flexion was made by intraplexus distal nerve transfers using a fascicle of the ulnar nerve (group A, n = 43), or a fascicle of the median nerve (group B, n = 16) or a combination of both (group C, n = 19). The result of the treatment was defined based on the British Medical Research Council grading system: muscle strength < M3 was considered a poor result. Results The global incidence of good/excellent results with these nerve transfers was 80.7%, and for different surgical techniques (groups A, B, C), it was 86%, 56.2% and 100% respectively. Patients submitted to ulnar nerve transfer or double transfer (ulnar + median fascicles transfer) had a better outcome than those submitted to median nerve transfer alone (p < 0.05). There was no significant difference between the outcome of ulnar transfer and double transfer. Conclusion In cases of traumatic injury of the upper brachial plexus, good and excelent results in the restoration of elbow flexion can be obtained using distal nerve transfers.

Download Full-text