Nerve Transfers for Upper Extremity Reanimation in Tetraplegia: Part II—Reinnervation Strategies and Clinical Outcomes

The operative strategy for nerve transfer in tetraplegia is tailored to the individual patient’s functional deficits and reinnervation goals. Information obtained from the history, physical examination, and electrodiagnostic studies permits the development of a strategy for nerve transfer based on the level of injury, a patient’s reinnervation priorities for functional recovery, and the available donor and recipient nerve pairings for transfer (Table 1). The operative techniques for nerve transfers to restore thumb and finger flexion, thumb and finger extension, and elbow extension have previously been reported. Descriptions of the surgical technique are located within the suggested readings. The objective of Part II in the current 2-part review article is to present results for the various reinnervation strategies and to suggest areas for future research in targeting upper extremity neurorestoration in tetraplegia.