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Nerve Transfers for the Upper Extremity: New Horizons in Nerve Reconstruction

Lee, Steve K. MD; Wolfe, Scott W. MD

Journal of the American Academy of Orthopaedic Surgeons: August 2012 - Volume 20 - Issue 8 - p 506–517
doi: 10.5435/JAAOS-20-08-506
Review Article

Nerve transfers are key components of the surgeon's armamentarium in brachial plexus and complex nerve reconstruction. Advantages of nerve transfers are that nerve regeneration distances are shortened, pure motor or sensory nerve fascicles can be selected as donors, and nerve grafts are generally not required. Similar to the principle of tendon transfers, expendable donor nerves are transferred to denervated nerves with the goal of functional recovery. Transfers may be subdivided into intraplexal, extraplexal, and distal types; each has a unique role in the reconstructive process. A thorough diagnostic workup and intraoperative assessment help guide the surgeon in their use. Nerve transfers have made a positive impact on the outcomes of nerve surgery and are essential tools in complex nerve reconstruction.

From the Hospital for Special Surgery and Weill Cornell Medical College, New York, NY.

Dr. Lee or an immediate family member has received royalties from, is a member of a speakers' bureau or has made paid presentations on behalf of, and serves as a paid consultant to or is an employee of Arthrex; serves as an unpaid consultant to Synthes; has received research or institutional support from Arthrex, DePuy Mitek, Integra LifeSciences, Medartis, Axogen, and Checkpoint; and serves as a board member, owner, officer, or committee member of the American Society for Surgery of the Hand. Dr. Wolfe or an immediate family member has received royalties from Extremity Medical; is a member of a speakers' bureau or has made paid presentations on behalf of Small Bone Innovations and TriMed; serves as a paid consultant to or is an employee of Extremity Medical and Small Bone Orthopedics; and serves as a board member, owner, officer, or committee member of the New York Society for Surgery of the Hand.

© 2012 by American Academy of Orthopaedic Surgeons
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