title: Double Distal Intraneural Fascicular Nerve Transfers for Lower Brachial Plexus Injuries.
abstract: OBJECTIVE
  To evaluate outcomes following transfer of the supinator motor branch of the radial nerve (SMB) to the posterior interosseous nerve (PIN) and the pronator teres motor branch of median (PTMB) to the anterior interosseous nerve (AIN) in patients with lower brachial plexus injuries.
  
  
  METHODS
  Since December 2010, 4 patients have undergone combined transfer of the SMB to PIN and PTMB to AIN for lower brachial plexus palsies. The study was prospectively designed, and the patients were followed for 4 years to monitor their functional improvement.
  
  
  RESULTS
  One patient failed to return after his 4-month postoperative visit. The other 3 patients all regained M4 thumb and finger extension, and 2 recovered M4 thumb and finger flexion at the final evaluation, a mean 30 months after the nerve transfer surgeries.
  
  
  CONCLUSIONS
  Combined transfer of the SMB to PIN and PTMB to AIN may lead to successful recovery of digital extrinsic flexion and extension in lower brachial plexus injuries.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC. Electronic address: zli@wakehealth.edu.
authors.forename: Zhongyu
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Plastic and Reconstructive Surgery, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Michael
authors.initials: M
authors.lastname: Reynolds
authors.affiliation: Department of Plastic and Reconstructive Surgery, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Ellen
authors.initials: E
authors.lastname: Satteson
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Omar
authors.initials: O
authors.lastname: Nazir
authors.affiliation: Department of Plastic and Reconstructive Surgery, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: James
authors.initials: J
authors.lastname: Petit
authors.affiliation: Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Beth P
authors.initials: BP
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D001917:Brachial Plexus / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016067:Nerve Transfer; D011446:Prospective Studies; D011826:Radial Nerve / Q000601:surgery*; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult
keywords: Lower brachial plexus injury; hand reanimation; nerve transfer