title: The double fascicular nerve transfer for restoration of elbow flexion.
abstract: BACKGROUND
  Injuries to the upper trunk of the brachial plexus are debilitating, affecting primarily shoulder abduction and elbow flexion. Treatment is aimed at restoring shoulder stabilization, shoulder abduction, and elbow flexion and may be accomplished by nerve grafting, nerve transfer, or functional muscular transfer.
  
  
  OBJECTIVE
  To describe the double fascicular nerve transfer with the goal of restoring elbow flexion.
  
  
  METHODS
  The double fascicular nerve transfer involves transferring an ulnar nerve fascicle to the musculocutaneous nerve innervating the biceps muscle and a median nerve fascicle transfer to a branch of musculocutaneous nerve supplying the brachialis muscle.
  
  
  RESULTS
  The double fascicular nerve transfer is effective in restoring elbow flexion after severe upper-trunk brachial plexus injuries.
  
  
  CONCLUSIONS
  Advantages of this procedure are that the nerve repair is done very close to the target muscle for reinnervation, so time to reinnervation is minimized, and the surgery takes place distal to the site of injury in nontraumatized tissue.
authors.affiliation: Department of Neurosurgery, University of South Carolina School of Medicine, Columbia, South Carolina, USA.
authors.forename: Charles P
authors.initials: CP
authors.lastname: Toussaint
authors.forename: Eric L
authors.initials: EL
authors.lastname: Zager
mesh_terms: D001917:Brachial Plexus / Q000293:injuries* / Q000601:surgery*; D004551:Elbow Joint / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008475:Median Nerve / Q000637:transplantation*; D016067:Nerve Transfer / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology; D014459:Ulnar Nerve / Q000637:transplantation*