Motor Nerve Transfers

Brachial plexus and peripheral nerve injuries are exceedingly common. Traditional nerve grafting reconstruction strategies and techniques have not changed significantly over the last 3 decades. Increased experience and wider adoption of nerve transfers as part of the reconstructive strategy have resulted in a marked improvement in clinical outcomes. We review the options, outcomes, and indications for nerve transfers to treat brachial plexus and upper- and lower-extremity peripheral nerve injuries, and we explore the increasing use of nerve transfers for facial nerve and spinal cord injuries. Each section provides an overview of donor and recipient options for nerve transfer and of the relevant anatomy specific to the desired function. ABBREVIATIONS: AIN, anterior interosseous nerve ECRB, extensor carpi radialis brevis FCR, flexor carpi radialis FCU, flexor carpi ulnaris FDP, flexor digitorum profundus FDS, flexor digitorum superficialis FPL, flexor pollicis longus MCN, musculocutaneous nerve MPN, medial pectoral nerve MRC, Medical Research Council PIN, posterior interosseous nerve SAN, spinal accessory nerve SCI, spinal cord injury TDN, thoracodorsal nerve