Nerve transfer

Coaptation of an expendable donor nerve or fascicle to the distal stump of an injured nerve close to its target, converting a proximal injury into a distal one with a single tension-free repair and no graft. Used for brachial plexus and high nerve injuries and for delayed presentations within the motor reinnervation window; the Oberlin and anterior interosseous-to-ulnar transfers are the classic examples.

Related terms

• Procedure

  Oberlin transfer

  Transfer of one or two fascicles, about 10 per cent of the bulk of the ulnar nerve, directly to the motor branch to biceps to restore elbow flexion after C5–C6 brachial plexus avulsion, described by Oberlin in 1994 without significant loss of hand function. The double fascicular modification adds a median nerve fascicle to the brachialis branch.

• Procedure

  Supercharged end-to-side transfer

  End-to-side coaptation of the distal anterior interosseous nerve to the ulnar motor branch, leaving the injured ulnar nerve in continuity, described by Barbour and Mackinnon. Intended for second- and third-degree axonotmetic injuries and severe compression, to augment partial recovery or to 'babysit' the intrinsic motor end plates until native axons regenerate; not a replacement for repair of a complete transection.

• Anatomy

  Motor end plate

  The neuromuscular junction at which a motor axon terminal meets the muscle fibre. After denervation the end plate can maintain its integrity for up to about a year, but progressive muscle fibrosis makes functional reinnervation unlikely beyond 12–18 months — the window that drives early repair and nerve transfer.

Articles mentioning this term

1. FESSH preparation · 26 September 2026

   Peripheral nerve injury and repair

   Peripheral nerve injury for FESSH candidates: degeneration, Seddon and Sunderland grades, electrodiagnosis, timing, grafts, conduits and nerve transfers.

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