Background :Nerve transfer surgery involves taking nerve branches from a neighboring nerve and redirecting them to the distal end of the injured nerve(1). A high-level nerve injuries with extensive gap , Major bony or vascular injuries Time from injury ,prolonged beyond that acceptable for grafting , Segmental nerve injury requiring several grafts , Segmental nerve injury with no grafts available ,Scarred area of injury containing vital structures with unacceptable risk of operative injury , Partial nerve injury with a defined functional loss ,Injuries of undefined level such as radiation trauma. (2) . So early intervention for traumatic brachial plexus and peripheral nerve injuries is recommended to get good results with pain relief (2). the aim of the study is to evaluate outcomes of nerve transfer surgeries and their outcomes as a method of nerve repair the methods the patients were tested for full labs and pre operative EMG and nerve conduction tests ,MRI were done the procedures were followed for about 6months and comparing motor power and sensation score according to scale of medical research council and DASH score preoperatively and post operatively the results on 20 patients were done at zagazig university hospitals The mean age of the studied patients was 23.3 ±11.3 years. There was a male predominance (85.0%) The most frequent mode of trauma was RTA (40.0%), Regarding the level of injury, more than half had an injury at the brachial plexus (55.0%) The most frequent procedure done was Spianl accessory Nerve to Supra scapular nerve transfer (31.9%), followed by anterior interosseous nerve to the deep motor branch of the ulnar nerve transfer (26.5%), Intercostals to musculocutaneous nerve transfer (20.6%) and long head of Triceps(11.8%) ,FCR branch from Median to Musculocutaneous nerve Post-operatively, about one third (32.4%) had M5 muscle power according to Medical Research Council scale (MRC) and M4 muscle power 26.5% compared to two-thirds (61.8%) had M0 muscle power, and about one-third (38.2%) had M1 muscle according to motor power scale, The median DASH score significantly declined from 30 pre-operative to 26 post-operative (P = 0.001). |
