Technique of the Double Nerve Transfer to Recover Elbow Flexion in C5, C6, or C5 to C7 Brachial Plexus Palsy

@article{Goubier2007TechniqueOT,
  title={Technique of the Double Nerve Transfer to Recover Elbow Flexion in C5, C6, or C5 to C7 Brachial Plexus Palsy},
  author={Jean No{\"e}l Goubier and Fr{\'e}d{\'e}ric Teboul},
  journal={Techniques in Hand and Upper Extremity Surgery},
  year={2007},
  volume={11},
  pages={15-17}
}
  • J. Goubier, F. Teboul
  • Published 1 March 2007
  • Medicine
  • Techniques in Hand and Upper Extremity Surgery
In C5, C6, or C5-to-C7 root injuries, many surgical procedures have been proposed to restore active elbow flexion. Nerve grafts or nerve transfers are the main techniques being carried out. The transfer of ulnar nerve fascicles to the biceps branch of the musculocutaneous nerve is currently proposed to restore active elbow flexion. Recovery of biceps muscle function is generally sufficient to obtain elbow flexion. However, the strength of elbow flexion is sometimes weak because the brachialis… 
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Transfer of the Intercostal Nerves to the Nerve of the Long Head of the Triceps to Recover Elbow Extension in Brachial Plexus Palsy
TLDR
The technique of intercostal nerve transfer to the long head of the triceps branch to restore elbow extension in brachial plexus palsy is presented and the reinnervated triceps can be transferred.
Upper Brachium Approach: The “Ulnar-Biceps Median-Brachialis” Double Nerve Transfer
TLDR
The “Ulnar-Biceps Median-Brachialis” double nerve transfer described by Oberlin became a standard procedure in C5-C6 and C5 of brachial plexus palsies affecting the upper roots.
Nerve transfer to the triceps after brachial plexus injury: report of four cases.
Transfer of a Motor Fascicle From the Ulnar Nerve to the Branch of the Radial Nerve Destined to the Long Head of the Triceps for Restoration of Elbow Extension in Brachial Plexus Surgery: Technical Case Report
TLDR
The attempted nerve transfer was effective for restoration of elbow extension in primary brachial plexus surgery; however, it should be selected only for cases in which other reliable donor nerves were used to restore elbow flexion.
Is fascicular selection by nerve stimulation techniques a necessity in selective nerve transfers targeted at restoration of elbow flexion in upper brachial plexus injuries
Double Fascicular Nerve Transfer to Musculocutaneous Branches for Restoration of Elbow Flexion in Brachial Plexus Injury
TLDR
The double fascicular transfer to musculocutaneous may be a safe and effective treatment for restoration of elbow flexion and is associated with superior functional outcomes when performed within the first six months from the injury.
Nerve transfers in children with traumatic partial brachial plexus injuries.
TLDR
Two children (9 and 12 years old) with C5 and C6 traumatic brachial plexus avulsion lesions are presented, where elbow flexion and shoulder abduction and external rotation were the functions to be restored.
Computer simulation of nerve transfer strategies for restoring shoulder function after adult C5 and C6 root avulsion injuries.
Results of Nerve Transfer in C5-C6 Traumatic Brachial Plexus Palsy
There were 19 men and 02 women; the mean age was 36 years (range 08-65 years). The most common mechanism of injury motor vehicle collision (17 patients), followed by motorcycle accident (03 patients)…
The Inverted Free Functioning Gracilis Muscle Transfer For Restoration of Elbow Flexion Following Delayed Presentation or Failed Primary Nerve Reconstruction of Upper Trunk Injuries
TLDR
This work has inverted the conventional free functional gracilis orientation so as to orient the flap’s recipient nerve in closer proximity to donor median or ulnar nerve fascicles to enable a short, tension-free coaptation in the middle to distal arm.
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References

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Transfer of fascicles from the ulnar nerve to the nerve to the biceps in the treatment of upper brachial plexus palsy.
TLDR
A secondary Steindler flexorplasty is indicated for patients who have persistent grade-3 elbow flexion strength or worse for at least twelve months after nerve fascicle transfer, which spares the C5 nerve root and other nerves for grafting or transfer elsewhere.
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