title: Double fascicular nerve transfer to the biceps and brachialis muscles after brachial plexus injury: clinical outcomes in a series of 29 cases.
abstract: OBJECTIVE
  The clinical outcomes of patients with brachial plexus injuries who underwent double fascicular transfer (DFT) using fascicles from the median and ulnar nerves to reinnervate the biceps and brachialis muscles were evaluated.
  
  
  METHODS
  The authors conducted a retrospective chart review of 29 patients with brachial plexus injuries that were treated with DFT for restoration of elbow flexion. All patients underwent pre- and postoperative clinical evaluation using the Medical Research Council grading system.
  
  
  RESULTS
  The mean patient age was 37 years (range 17-68 years), and there was a mean follow-up of 19 ± 12 months (range 8-68 months). At the most recent follow-up, all but 1 patient (97%) had regained elbow flexion. Eight patients recovered Grade M5, 15 patients recovered Grade M4, and 4 patients recovered Grade M3 elbow flexion strength. There was no evidence of functional deficit in the donor nerve distributions.
  
  
  CONCLUSIONS
  Study results demonstrated the reliable restoration of M4-M5 elbow flexion following double fascicular transfer in patients with brachial plexus injuries.
authors.affiliation: Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
authors.forename: Wilson Z
authors.initials: WZ
authors.lastname: Ray
authors.forename: Mitchell A
authors.initials: MA
authors.lastname: Pet
authors.forename: Andrew
authors.initials: A
authors.lastname: Yee
authors.forename: Susan E
authors.initials: SE
authors.lastname: Mackinnon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001917:Brachial Plexus / Q000293:injuries* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation / Q000601:surgery*; D016067:Nerve Transfer / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology; D016896:Treatment Outcome