Understanding the procedure
A functioning nerve or selected fascicle is connected to a nerve supplying a target that has lost its input. In motor reconstruction, a connection closer to the target muscle may reduce the distance for regeneration. The donor must be chosen to balance potential benefit against loss of its original function.
When might it be considered?
- Selected brachial plexus or peripheral nerve injuries with limited recovery potential.
- A priority movement, such as elbow flexion, that may be reconstructed.
- Suitable donor nerves and a recipient muscle or sensory target capable of benefiting.
Specialist assessment
Examination and nerve tests assess both donor and recipient function. The injury level, time elapsed, muscle condition and previous reconstruction all matter. Not every paralysed muscle remains a suitable target indefinitely.
Treatment & recovery
Surgery is followed by protection and focused rehabilitation to activate and retrain the new connection. Recovery takes months and varies between targets. Risks include donor weakness or altered sensation, failure to reinnervate and incomplete functional improvement.
Common questions
How is a nerve transfer different from a tendon transfer?
A nerve transfer redirects nerve signals. A tendon transfer redirects the pull of a functioning muscle. Their suitability and rehabilitation differ.
Will I need specialist therapy?
Yes. Learning to recruit the new nerve pathway and turn it into useful movement is an important part of treatment.
General patient information from London Nerve Injury. Decisions about investigations and treatment require an individual clinical assessment.