Why are nerve transfers done?
Author: Kelsey Zhao | Reviewer: Michael Berger, Christopher Doherty | Published: 23 January 2024 | Updated: ~
Since the success of nerve transfer techniques were demonstrated in other nerve injuries, like brachial plexus injury, they are now being applied to SCI. Nerve transfers are usually done after a cervical SCI to regain movement in the upper limbs. Some functions commonly targeted in nerve transfers include elbow extension, wrist extension, finger extension, finger flexion, and finger extension.
Table 1: Common nerve transfer surgeries and the donor/recipient nerves that can be used to restore each muscle function.2-5
Function |
Donor |
Recipient |
|
|
Teres minor nerve | Triceps nerve |
| Teres minor and motor portion of posterior division of axillary nerve | Triceps nerve | |
| Motor portion of posterior division of axillary nerve | Triceps nerve | |
| Fascicle of anterior division of axillary nerve | Triceps nerve | |
|
|
Supinator nerve | ECRB (Extensor carpi radialis brevis) nerve |
|
|
Supinator nerve | PIN (Posterior interosseous nerve) |
|
|
Brachialis nerve | AIN (Anterior interosseous nerve) |
| ECRB nerve | AIN | |
| Supinator nerve | AIN | |
| Fascicle to pronator teres nerve | FDS (Flexor digitorum superficialis) nerve |
Although wrist extension (bend wrist up) and wrist flexion (bend wrist down) can be targeted with nerve transfer, wrist movement is often reconstructed with tendon transfers instead. Learn more about tendon transfers in the How do nerve transfers compare to tendon transfers? section below.
Improved movement in the arms and hands can increase an individual’s independence and confidence in many areas of life, including daily activities, mobility, and socializing.
This YouTube video explains the basics of nerve transfer and tendon transfer surgeries, and the differences between the two. This video was created by Neramy Ganesan, a graduate of the University of Toronto MSc Biomedical Communications Program, with the help of content expert Dr. Jana Dengler at Sunnybrook Health Sciences Centre. Please see the end credits in the video for more details.6
