Nerve transfers for the upper extremity: new horizons in nerve reconstruction

J Am Acad Orthop Surg. 2012 Aug;20(8):506-17. doi: 10.5435/JAAOS-20-08-506.


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.

Publication types

  • Review

MeSH terms

  • Accessory Nerve / transplantation
  • Axilla / innervation
  • Brachial Plexus Neuropathies / surgery*
  • Contraindications
  • Humans
  • Intercostal Nerves / transplantation
  • Musculocutaneous Nerve / surgery
  • Nerve Transfer / methods*
  • Phrenic Nerve / transplantation
  • Plastic Surgery Procedures / methods
  • Tenodesis
  • Terminology as Topic
  • Thoracic Nerves / surgery
  • Ulnar Nerve / transplantation
  • Upper Extremity / innervation
  • Upper Extremity / surgery*