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77th ASSH Annual Meeting - Back to Basics: Practic ...
IC06: Why Didn't My Nerve Transfer Work? And Now W ...
IC06: Why Didn't My Nerve Transfer Work? And Now What Do I Do? (AM22)
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Video Transcription
Video Summary
Dr. Alex Shin discusses the factors that can lead to a nerve transfer for elbow flexion failing, emphasizing the importance of careful decision making and surgical technique. He notes that using injured nerves for transfers can decrease success rates and that accurately measuring outcomes can be challenging. Dr. Shin recommends considering alternative treatment options, such as amputation and myoelectric fitting, or using free muscle transfers with available donor nerves when nerve transfers fail. He urges surgeons to think creatively and consider all possibilities for patients who have failed nerve transfers. However, he also acknowledges that in some cases, there may be no further treatment options available and surgeons should be honest with their patients about this. Dr. Shin concludes by recommending a chapter by Amy Moore on outcomes and treatment options for failed nerve transfers as a valuable resource for surgeons.<br /><br />The video transcript focuses on ulnar nerve transfers for intrinsic function. The speaker highlights the importance of patient selection and timing for optimal outcomes. Different techniques, such as the AIN to ulnar motor nerve transfer and the transfer of the opponent's pollicis branch of the median nerve, are discussed. The speaker emphasizes the technical aspects of these operations, including tension-free coaptation. Nerve transfers are shown to have better outcomes compared to nerve grafting alone. If nerve transfers fail, salvage options like tendon transfers may be considered. The speaker underscores the significance of post-operative rehabilitation and the use of surface EMG biofeedback to aid in muscle activation. Overall, successful outcomes depend on patient selection, skilled surgery, and appropriate rehabilitation.
Meta Tag
Session Tracks
Microsurgery
Session Tracks
Nerve
Session Tracks
Shoulder/Elbow
Session Tracks
Tendon
Speaker
Alexander Y. Shin, MD
Speaker
Bryan J. Loeffler, MD
Speaker
Christopher J. Dy, MD, MPH, FACS
Speaker
David M. Brogan, MD, MSc.
Speaker
Hollie Power, MD
Speaker
Jayme A. Bertelli, MD, PhD
Keywords
nerve transfer
elbow flexion
careful decision making
surgical technique
alternative treatment options
failed nerve transfers
ulnar nerve transfers
patient selection
tendon transfers
rehabilitation
successful outcomes
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