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 with 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 there is increasing adoption of these techniques as the published evidence matures. The advantages of nerve transfers include shorter reinnervation distances, restoring the original muscle action, and maintenance of independent muscle function. Tendon transfers are more reliable, functional use of the limb is often achieved more quickly and they are not time-dependent. Hybrid combinations are also possible where nerve and tendon transfers are combined to maximize the recovery potential. This scoping review aims 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.