HOT TOPIC: Nerve Transfers in the Upper Extremity

Abstract

Nerve injuries to the upper extremity can have devastating functional consequences for patients. The gold standard of treatment when an irreducible nerve defect is not present is prompt, tension-free, primary repair. However, when a nerve gap does exist, an alternative form of reconstruction, such as nerve grafting, must be utilized. Traditionally, nerve grafting has been met with slow and suboptimal results, particularly with more proximal nerve injuries. The use of nerve transfers in peripheral nerve reconstruction is an expanding and ever-evolving field that endeavors to improve these outcomes. This article reviews the basic principles of nerve transfer, indications and contraindications for use, and some of the critical surgical techniques necessary to perform them.

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