Useful Functional Outcome Can be Achieved after Motor Nerve Transfers in Management of the Paralytic Hand. An Observational Study

Abstract

Background: Nerve transfers have demonstrated encouraging outcomes in peripheral nerve reconstructions compared with the conventional direct repair or grafting.

Impact of Body Mass Index and Comorbidities on Outcomes in Upper Extremity Nerve Transfers

“…12 Similarly, in their cohort of 55 patients who underwent nerve transfers for isolated injuries of radial, ulnar, and median nerves, Sallam et al found a downward trend in motor grade with increased BMI. 13 Consistent with Lee et al, they speculated that the poor fitness of patients with higher BMIs was a likely explanation for these findings. 12,13 Socolovsky et al published an interesting series of papers exploring the impact of BMI on nerve transfer outcomes.…”

“…13 Consistent with Lee et al, they speculated that the poor fitness of patients with higher BMIs was a likely explanation for these findings. 12,13 Socolovsky et al published an interesting series of papers exploring the impact of BMI on nerve transfer outcomes. 14,15 In their initial study, Socolovsky et al demonstrated that elevated BMI negatively impacted recovery of shoulder abduction in 18 patients who received spinal accessory to suprascapular nerve transfer for shoulder reanimation in brachial plexus injuries.…”

“…5 A literature review was executed to identify clinical research addressing the impact of BMI on nerve transfer outcomes-the current body of literature is summarized in ►Table 7. There is a dearth of evidence and the existing results remain equivocal, with three studies [12][13][14] suggesting a negative correlation between BMI and functional recovery following nerve transfer, and four studies [15][16][17][18] suggesting no relationship. Some of the earliest clinical work exploring the relationship between BMI and nerve transfer outcomes came from Lee et al who conducted a retrospective cohort study of 21 patients who were treated for isolated axillary nerve injuries with triceps motor branch transfers.…”

Autologous Fibrin Glue Versus Microsuture in the Surgical Reconstruction of Peripheral Nerves: A Randomized Clinical Trial

“…21,22 Functional motor recovery was considered useful when a grade of M3 or more was achieved, and functional sensory recovery was considered useful when a grade of S3 or more was regained. 23,24 The Tinel sign and 2-point discrimination were used to evaluate the progress of nerve regeneration at 6 and 12 weeks after surgery and at 3-month intervals thereafter. Operative time for the microsuture group was the time required for the placement of 6 epineurial sutures; while for the fibrin glue group, it was the time necessary for sealant application, plus a standard setting time of 5 minutes.…”

Foot Reanimation Using Double Nerve Transfer to Deep Peroneal Nerve: A Novel Technique for Treatment of Neurologic Foot Drop

“…The concept of nerve transfer for functional loss due to peripheral nerve injury has been described in the upper extremity. 15,33,34,38 Various anatomical feasibility studies, similarly, supported the use of a single nerve transfer technique for the treatment of neurologic foot drop. 1,9,29 Tibial nerve branches to the lateral head of the gastrocnemius, 23,25 soleus, 3,8,10,25 or flexor hallucis longus (FHL) and flexor digitorum longus (FDL) muscles 14 were previously investigated as possible donors to neurotize the injured deep peroneal nerve.…”