The author summarises the application of nerve transfers in upper limb trauma. This is a review article and covers the principles of transfer; the indications, preoperative assessment and the whole patient journey, stressing the need for rehabilitation. The technical factors of this surgery are highlighted. The benefits of nerve transfers versus nerve grafting or tendon transfers are discussed. The article recounts the very successful early work for shoulder function and elbow flexion, but also looks at the potential applications distal to the brachial plexus, particularly to prevent the complications of ulnar nerve injury. The reader is informed of the options for sensory as well as motor nerve transfers. The author then lists the preferences for each level of injury in descending order. This is a very practical and yet provoking paper which encourages the reader to review their own treatment options and to extend their own treatment armamentarium where appropriate.
A place for nerve transfers in your hand surgery service
Reviewed by Stuart Hamilton
Nerve transfers.
