Biomaterial Database

Nerve transfers in the hand and upper extremity surgery. 2008

Susan E Mackinnon, and Stephen H Colbert

Division of Plastic and Reconstructive Surgery Department of Surgery Washington University School of Medicine St. Louis, MO, USA. mackinnon@wudosis.wustl.edu

Modern nerve-to-nerve transfers represent one of the greatest advances in peripheral nerve surgery. Lessons of tendon transfers have taught that nerves to specific musculotendinous units are expendable, and greater understanding of peripheral nerve topography has revealed redundant fascicles in peripheral nerves. Transfer of these redundant or expendable nerves to recipient nerves close to the end organ allows for earlier reinnervation and preservation of those musculotendinous units. Such nerve transfers provide significantly better treatment options in many cases of nerve injury where previous outcomes were expected to be poor, such as with proximal injuries, long nerve gaps, or unavailability of the proximal injured segment. This article will review current nerve transfers in the hand and upper extremity.

UI	MeSH Term	Description	Entries
D010525	Peripheral Nerves	The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium.	Endoneurium,Epineurium,Perineurium,Endoneuriums,Epineuriums,Nerve, Peripheral,Nerves, Peripheral,Perineuriums,Peripheral Nerve
D006225	Hand	The distal part of the arm beyond the wrist in humans and primates, that includes the palm, fingers, and thumb.	Hands
D006230	Hand Injuries	General or unspecified injuries to the hand.	Injuries, Hand,Hand Injury,Injury, Hand
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000075202	Contraindications	A condition or factor associated with a recipient that makes the use of a drug, procedure, or physical agent improper or inadvisable. Contraindications may be absolute (life threatening) or relative (higher risk of complications in which benefits may outweigh risks).	Contraindications, Physical Agent,Medical Contraindications,Agent Contraindication, Physical,Agent Contraindications, Physical,Contraindication,Contraindication, Medical,Contraindication, Physical Agent,Contraindications, Medical,Medical Contraindication,Physical Agent Contraindication,Physical Agent Contraindications
D016067	Nerve Transfer	Surgical reinnervation of a denervated peripheral target using a healthy donor nerve and/or its proximal stump. The direct connection is usually made to a healthy postlesional distal portion of a non-functioning nerve or implanted directly into denervated muscle or insensitive skin. Nerve sprouts will grow from the transferred nerve into the denervated elements and establish contact between them and the neurons that formerly controlled another area.	Nerve Crossover,Neurotization,Crossover, Nerve,Crossovers, Nerve,Nerve Crossovers,Nerve Transfers,Neurotizations,Transfer, Nerve,Transfers, Nerve
D059348	Peripheral Nerve Injuries	Injuries to the PERIPHERAL NERVES.	Peripheral Nerve Injury,Nerve Injuries, Peripheral,Nerve Injury, Peripheral
D034941	Upper Extremity	The region of the upper limb in animals, extending from the deltoid region to the HAND, and including the ARM; AXILLA; and SHOULDER.	Extremity, Upper,Membrum superius,Upper Limb,Extremities, Upper,Limb, Upper,Limbs, Upper,Upper Extremities,Upper Limbs