Title: Double Fascicular Nerve Transfer - Median/Ulnar Fascicles to Biceps/Brachialis Branches.
Published: 4/11/2011, Updated: 4/11/2011.
Author(s): Susan E. Mackinnon MD, Andrew Yee BS.
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO.
The double fascicular transfer is the choice nerve transfer of our institution for musculocutaneous nerve palsies. In cases that involve an unusual direct injury to the musculocutaneous nerve and a site of injury close to target, a direct nerve repair or nerve graft is the more appropriate surgical intervention. The double fascicular transfer utilizes nerve fascicules to the flexor digitorum superficialis/flexor carpi radialis of the median nerve and the flexor carpi ulnaris of the ulnar nerve to reinnervate the biceps brachii and brachialis muscles. This procedure was established by the senior author as a modification of the single fascicular Oberlin transfer to include the brachialis muscle as a target for reinnervation in addition to the biceps brachii muscle. At our institution, the double fascicular transfer has proven to be an excellent procedure for recovering musculocutaneous nerve function by utilizing two donor nerve fascicles, flexor digitorum superficialis/flexor carpi radialis and flexor carpi ulnaris, to reinnervate two targets, biceps brachii and brachialis.