American Society for Peripheral Nerve American Society for Peripheral Nerve
ASPN 2019 Annual Meeting
February 1-3, 2019
JW Marriott Hotel
Palm Desert, California

ASPN 2020 Annual Meeting
January 10-12, 2020
Marriott Harbor Beach
Fort Lauderdale, Florida

ASPN 2021 Annual Meeting
January 15 17, 2021
Grand Hyatt Kaua'i Resort
Koloa, Hawaii

ASPN Videos and Recordings on PSEN
ASPN members have complimentary access.


Back to 2015 Annual Meeting Program

Double Distal Nerve Transfer for Hand Reconstruction after Lower Brachial Plexus Injuries
Zhongyu Li, MD, PhD
Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC

Hypothesis: Lower brachial plexus injury (LBPI) remains a clinical challenge. Early distal nerve transfer may provide useful thumb and finger functional recovery.

Material & Methods: Four patients were treated with distal double nerve transfer for LBPI. There were 3 males and one female, 3 of them involved in the right side. The mean age at surgery was 22 (17-26) years old. The procedure includes transferring a pronator branch of the median nerve (PBMN) to the anterior interosseous nerve (AIN) and a supinator branch of the radial nerve (SBRN) to the posterior interosseous nerve (PIN). The mean time of delay from injury to surgery was 7.5 (5-13) months. The mean follow-up was 19 (6-36) months.

Results: The first 2 patients achieved M4 of EPL/EDC and M4 of FPL /FDP. The other two more recent patients showed signs of motor recovery 6-9 months after surgery. There was no functional loss of forearm pronation or supination after surgery.


  • Simultaneous double distal transfer of a PBMN to AIN and a SBRN to PIN is a reliable technique for patients with LBPI.
  • The advantages of this procedure include:
    1) transfers can be performed through one incision with minimal intraneural dissection;
    2) the transferred nerves are very close to the targeting muscles;
    3) there is no need for nerve graft;
    4) both transfers are in-phase with ease in post-op therapy.
  1. Gu Y, et al... Transfer of brachialis branch of musculocutaneous nerve for finger flexion: anatomic study and case report. Microsurgery. 2004;24:358-62
  2. Dong Z, et al. Clinical use of supinator motor branch transfer to the posterior interosseous nerve in C7-T1 brachial plexus palsies. J Neurosurg. 2010: 13:113-7
  3. Bertelli JA et at. Transfer of the pronator quadratus motor branch for wrist extension reconstruction in brachial plexus palsy. Plast Reconstr Surg. 2012;130:1269-78

Back to 2015 Annual Meeting Program
American Society for Peripheral Nerve
500 Cummings Center, Suite 4400, Beverly, MA 01915
Phone 978-927-8330  |  Email ASPN
© 2018 ASPN | Privacy Policy