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Updated: Oct 3, 2025
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Structured Motor Rehabilitation After Selective Nerve Transfers
Published on: August 15, 2019
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Sensorimotor Outcomes of Upper Extremity End-to-Side Nerve Transfers: A Meta-analysis
Matthew R Zeiderman1, Jeffrey Fine1, Derek B Asserson
1From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California Davis, Davis.
Annals of Plastic Surgery
|February 18, 2022
Summary
End-to-side nerve transfer (ETSNT) shows promising functional recovery for digital nerve injuries. While not influenced by age or time to surgery, ETSNT efficacy appears greater within the brachial plexus for peripheral nerve repair.
Area of Science:
- Neurosurgery
- Peripheral Nerve Regeneration
- Microsurgery
Background:
- End-to-side nerve transfer (ETSNT) is a surgical technique for peripheral nerve injuries with debated efficacy.
- Factors such as patient age, sex, transfer location, and surgical timing are hypothesized to influence outcomes.
Approach:
- A systematic literature review of PubMed (1988-2018) identified 11 studies with 115 patients undergoing ETSNT in the upper extremity.
- Data on patient demographics, surgical details, and functional recovery (Medical Research Council scale) were extracted.
- Statistical analyses, including chi-squared tests and logistic mixed-effect models, were employed to assess factors associated with meaningful recovery (MRC Grade ≥3).
Key Points:
- Neither continuous age nor time to surgery significantly impacted meaningful recovery.
- Injury mechanism, sex, and younger age (<25 years) were not associated with improved outcomes.
- ETSNT within the brachial plexus demonstrated significantly higher odds of meaningful recovery compared to distal arm transfers (OR, 41.9; P=0.04).
Conclusions:
- ETSNT is effective for digital nerve injuries, yielding meaningful sensory recovery.
- The brachial plexus appears to be a more efficacious location for ETSNT compared to the distal arm.
- Further research is warranted to fully elucidate the effectiveness of ETSNT in various upper extremity nerve injury scenarios.
