Common Nerve Transfers

Ulnar and/or Median fasicle to biceps and/or brachialis for elbow flexion: a fascicle (small sub-nerve) is taken from either or both of the ulnar and median nerve and re-routed into the biceps and/or brachialis muscle to try to regain elbow flexion.

Tricpes to Axillary nerve transfer: one fascicle that powers the triceps (leaving at least 2 behind to preserve elbow extension power) is used to re-innervate part the deltoid muscle to regain abduction and flexion function of the arm

Distal Accessory to Suprascapular Nerve transfer: The distal part of the nerve that powers the trapezius muscle is harvested.  Only the distal part is harvested to preserve upper function of the trapezius such as shoulder shrug function.  This part of the accessory nerve is then re-routed to re-innervate the suprascapular nerve to power both supraspinatus and infraspinatus muscles to help with motion around the shoulder, in particular external rotation.

Distal AIN to Ulnar motor: The end of the anterior interosseous nerve which serves pronator quadratus is sacrificed.  This leaves patients with very mild (in most cases imperceptible) pronation (palm turning down to ground) strength.  The AIN is the used to re-innervate the motor portion of the ulnar nerve in the distal forearm.  This is typically used to support a severe ulnar nerve injury more proximally such as  severe ulnar nerve compression at the elbow.

Obturator to partial femoral nerve transfer: A part of the obturator nerve which helps pull the legs together is sacrificed to power part of the femoral nerve to regain some knee extension (straightening) strength

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