Nerve transfers are increasingly utilized in the treatment of brachial plexus and peripheral nerve injuries. Despite the increase in surgeon interest in these techniques and the critical need for appropriate postoperative therapy, there is a lack of standardized rehabilitation protocols.
This unique book hopes to bridge this gap by presenting principles of nerve transfer rehabilitation, including timing and concepts for synergism and donor activation, as well as specific protocols for common nerve transfers. Part 1 provides an overview of nerve transfer surgery, the role of cortical reorganization, the psychosocial impact of brachial plexus injuries, as well as the principles of rehabilitation after nerve transfers. The principles emphasize motor re-education, cortical plasticity, and key concepts of recipient muscle recovery. Part 2 covers specific rehabilitation guidelines for 22 common nerve transfers of the upper extremity which aim to maximize recovery of function in the shoulder, elbow, wrist and hand. These include but are not limited to the Oberlin transfer, triceps to axillary nerve transfer, spinal accessory to suprascapular nerve transfer, intercostal nerve transfers, median to radial nerve transfers, and distal anterior interosseous nerve to ulnar motor transfer. This book serves as a clinical manual that includes tables, figures, and photos to help explain concepts and demonstrate rehabilitation exercises.
This book will be useful for a broad range of clinicians and specialists, including occupational and physical therapists, hand therapists, orthopedic and plastic surgeons, hand and elbow surgeons, neurosurgeons, neurologists, and physical medicine and rehabilitation specialists.
Part 1 Principles of Rehabilitation after Nerve Transfers.- Introduction
to Nerve Transfer Surgery.- Overview of Nerve Transfer Rehabilitation.- The
Role of Cortical Reorganization.- The Psychosocial Impact of Brachial Plexus
Injuries.- Part 2 Rehabilitation Guidelines for Specific Nerve Transfers:
Scapulothoracic.- Pectoralis Nerve to the Spinal Accessory Nerve Transfer.-
Thoracodorsal Nerve to the Long Thoracic Nerve Transfer.- Intercostal Nerves
to the Long Thoracic Nerve Transfer.- Part 3 Rehabilitation Guidelines for
Specific Nerve Transfers : Glenohumeral.- Spinal Accessory Nerve (SAN) to the
Suprascapular Nerve (SSN)Transfer.- Radial Nerve (Triceps Branch) to the
Axillary Nerve Transfer.- Medial Pectoral Nerve to the Axillary Nerve
Transfer.- Spinal Accessory Nerve to the Axillary Nerve Transfer.- Part 4
Rehabilitation Guidelines for Specific Nerve Transfers : Elbow.- Intercostal
Nerves to the Biceps Branch of the Musculocutaneous Nerve Transfer.- Ulnar
Nerve (Flexor Carpi Ulnaris/FCU Branch) to the Biceps Branch of the
Musculocutaneous Nerve Transfer.- Median Nerve (FCR/FDS Branch) to the
Brachialis Branch of the Musculocutaneous Nerve Transfer.- Intercostal Nerves
to the Triceps Branch of the Radial Nerve Transfer.- Axillary Nerve to the
Triceps Branch of the Radial Nerve Transfer.- Part 5 Rehabilitation
Guidelines for Specific Nerve Transfers : Wrist.- Median Nerve (Flexor
Digitorum Superficilias/FDS Branch) to the Extensor Carpi Radialis Brevis
Branch (ECRB) of the Radial Nerve Transfer.- Part 6 Rehabilitation Guidelines
for Specific Nerve Transfers : Hand.- Median Nerve (Flexor Carpi Radialis/FCR
Branch) to the Posterior Interosseous Nerve (PIN) Transfer.- Radial Nerve
(Supinator Branch) to the Posterior Interosseous Nerve (PIN) Transfer.-
Anterior Interosseous Nerve (AIN) (Pronator Quadratus/PQ Branch) to the
Distal Posterior Interosseous Nerve (PIN) Transfer.- Radial Nerve (Extensor
Carpi Radialis Brevis/ECRB Branch) to the Flexor Digitorum Superficialis
(FDS) Branch of the Median Nerve Transfer.- Radial Nerve (Extensor Carpi
Radialis Brevis/ECRB Branch) to the Anterior Interosseous Nerve (AIN)
Transfer.- Musculocutaneous Nerve (Brachialis Branch) to the Anterior
Interosseous Nerve (AIN) Transfer.- Ulnar Nerve (Abductor Digiti Minimi/ADM
Branch) to the Thenar Branch of the Median Nerve Transfer.- Anterior
Interosseous Nerve (AIN) (Pronator Quadratus/PQ Branch) to the Deep Ulnar
Motor NerveTransfer.- Median Nerve (Opponens Pollicis/OP Branch) to the First
Dorsal Interossei Branch of the Deep Ulnar Motor Nerve.
Lorna Canavan Kahn, PT, CHT
Milliken Hand Rehabilitation Center
Program in Physical Therapy
WashU Medicine
St. Louis, MO, USA
Macyn M. Stonner, OTD, CHT
Milliken Hand Rehabilitation Center
Program in Occupational Therapy
WashU Medicine
St Louis, MO, USA
Christopher Dy, MD, MPH, FACS
Department of Orthopedic Surgery
Division of Hand and Microsurgery
WashU Medicine
St. Louis, MO, USA
