Nerve transfers in the hand and upper extremity surgery.

Area of Science:

• Neurosurgery
• Peripheral Nerve Surgery
• Microsurgery

Background:

• Nerve transfers are a significant advancement in peripheral nerve surgery.
• Understanding of nerve topography reveals expendable or redundant nerve fascicles.
• Tendon transfer principles inform nerve transfer strategies.

Purpose of the Study:

• To review current nerve transfer techniques in the hand and upper extremity.
• To highlight the benefits of nerve transfers for treating peripheral nerve injuries.
• To discuss applications in cases with poor expected outcomes.

Main Methods:

• Review of current literature on nerve transfers in the upper extremity.
• Analysis of principles derived from tendon transfers.
• Examination of peripheral nerve topography and fascicular organization.

Main Results:

• Nerve transfers allow earlier reinnervation by utilizing expendable or redundant nerves.
• These transfers enable preservation of musculotendinous units.
• Improved treatment options are available for proximal injuries, long nerve gaps, and unavailable proximal segments.

Conclusions:

• Nerve transfers represent a major advance in treating peripheral nerve injuries.
• They offer superior functional recovery compared to previous methods in specific injury patterns.
• This technique provides valuable solutions for complex nerve reconstruction in the hand and upper extremity.