Peripheral nerves are critical anatomic structures that are essentially branches of the brain and spinal cord which allow muscles to function. When they get injured and stop working, patients loose critical function, whether it’s facial expression, sensation, or the ability to move their extremities. Many of these injuries are temporary, however some of them leave permanent deficits unless operated on. There are many creative options to help patients restore function, and nerve transfer surgery is one of them.
Fortunately, nature left the human body with lots of redundancy. For example, there are multiple muscles that extend the wrist, and therefore, the nerve of one of those muscles could be “sacrificed” to perform a different function, such as finger flexion. That is the basic principle of nerve transfer surgery, to take a nerve from an expendable muscle, and transfer it to a different muscle that isn’t working.
These procedures are all done under general anesthetic. They can be complex operations that require a considerable amount of operative time (eg. 5+ hours), or more routine operations.
The specifics of the operation are dependent on the condition being reconstructed. Dr. McInnes will explain this to you in detail and likely offer to show you videos of the operation you require, should it be helpful to your understanding.
Following your surgery, a dressing will be applied to your incisions and you may have a drain and a splint. You will likely be seen by Dr. McInnes 1-2 weeks after your surgery. You will be given specific instructions on how to care for the surgical site (and possibly drains), medications to apply or take orally to aid healing, specific concerns to look for, and when to follow up with Dr. McInnes. After 1-2 weeks, Dr. McInnes will instruct you on how to move the affected area, and will likely have you seen by a specific physiotherapist.
Results & Expected Outcome
You will not notice any new movement immediately after your nerve transfer procedure. In fact, it will take months before any new function is gained, and up to 2 years before your final results are achieved. Although functional results and improvement are expected from your procedure, like all things in medicine and surgery, there is never a guarantee. Nerve transfer surgery outcomes depend on numerous factors, including time from injury, location of injury, procedure required, technique, systemic health, smoking, compliance with rehabilitation etc. In many situations, it may not be possible to achieve optimal results with a single surgical procedure and a second surgery may be necessary.
For additional questions common to most surgeries, please see our FAQ page.