Motor nerve transfers for reconstruction of traumatic upper extremity nerve injuries - a scoping review

Peripheral nerve injuries to the radial, median, and ulnar nerves have been traditionally treated via direct repair or interposition nerve grafts. Late presentation or failed functional restoration may be salvaged with tendons transfers. Nerve transfers may be deployed either as an adjunct to a proximal reconstruction or as a primary reconstructive strategy, and these techniques are being increasingly adopted as the published evidence matures. The advantages of nerve transfers include shorter reinnervation distances, restoration of original muscle action, and maintenance of independent muscle function. Tendon transfers are reliable, not dependent on time, and the functional use of the limb is often achieved quickly,. Hybrid combinations that combine nerve and tendon transfers can also be used to maximize the recovery potential. This scoping review aimed to provide an overview of nerve transfer possibilities after peripheral nerve injuries and guide management decisions for clinicians treating patients with upper limb paralysis from peripheral nerve injuries.