Some controversies in nerve transfer for brachial plexus injuries

The intention of this study is to analyse some controversies in the most commonly used methods of nerve transfer (NT) in brachial plexus injuries. Analysis is based on results of 137 NT performed in 88 patients. Total rate of functional recovery was 70,1% and in individual procedures 84% for collateral branches NT, 45.7% for intercostal NT, 62.5% for spinal accessory NT, 64.2% for intraplexal NT and 87.1% for combined procedures. On the basis of the obtained results we made several conclusions: (I) reinnervation of the axillary nerve may be sufficient in reanimation of the shoulder abduction, (2) collateral branches NT is superior to the intraplexal NT, (3) medial pectoral nerve may be a useful donor, (4) combined use of donors gives a higher rare and better quality of recovery, (5) two intercostal nerves are enough to achieve useful function such as elbow flexion, and (6) intermediate technique of anastomosis is superior comparing to the standard technique in intercostal NT.