Abstract
In recent years nerve transfers have been increasingly used to broaden reconstructive
options for brachial plexus reconstruction. Nerve transfer is a procedure where an
expendable nerve is connected to a more important nerve in order to reinnervate that
nerve. This article outlines the experience of the Scottish National Brachial Plexus
Injury Service as our use of nerve transfers has increased. Outcomes have improved
for reconstruction of the paralysed shoulder using transfer of the accessory nerve
to the suprascapular nerve. Medial pectoral to musculocutaneous nerve transfer has
proved reliable for restoration of elbow flexion for patients with C5,6 and C5,6,7
injuries. Problems with nerve transfers include morbidity in the donor nerve territory,
co-contraction, and pre-existing injury to the donor nerve. There is a balance of
risks in these procedures which should be weighed up in individual cases.
Keywords
Brachial plexus - Injury - Nerve graft - Nerve transfer
