When brachial plexus injury has occurred, and nerves have been avulsed from the cervical spinal ... read more ↘ cord, reconstructive strategies center around nerve transfer surgery. When injury is limited to the 5th and 6th cervical roots, and elbow extension and hand function are retained, an "Oberlin" transfer is an excellent option, which avoids the morbidity of having to perform intercostal nerve transfers. The surgery involves transferring 1-2 fascicles from the functioning ulnar nerve to the motor branch to the biceps muscle. The goal is elbow flexion that is strong enough to overcome gravity and perform light lifting.
Intraoperative ulnar fascicular stimulation ellicits wrist flexion from stimulation of that portion of the ulnar nerve that innervates the FCU muscle; these fascicles are used for transfer to the motor nerve to biceps. ↖ read less
