Rehabilitation for Nerve Transfers of the Upper Extremity: A Clinical Manual

Nerve transfers are increasingly utilized in the treatment of brachial plexus and peripheral nerve injuries. Despite the increase in surgeon interest in these techniques and the critical need for appropriate postoperative therapy, there is a lack of standardized rehabilitation protocols. This unique book hopes to bridge this gap by presenting principles of nerve transfer rehabilitation, including timing and concepts for synergism and donor activation, as well as specific protocols for common nerve transfers. Part 1 provides an overview of nerve transfer surgery, the role of cortical reorganization, the psychosocial impact of brachial plexus injuries, as well as the principles of rehabilitation after nerve transfers. The principles emphasize motor re-education, cortical plasticity, and key concepts of recipient muscle recovery. Part 2 covers specific rehabilitation guidelines for 22 common nerve transfers of the upper extremity which aim to maximize recovery of function in the shoulder, elbow, wrist and hand. These include but are not limited to the Oberlin transfer, triceps to axillary nerve transfer, spinal accessory to suprascapular nerve transfer, intercostal nerve transfers, median to radial nerve transfers, and distal anterior interosseous nerve to ulnar motor transfer. This book serves as a clinical manual that includes tables, figures, and photos to help explain concepts and demonstrate rehabilitation exercises. This book will be useful for a broad range of clinicians and specialists, including occupational and physical therapists, hand therapists, orthopedic and plastic surgeons, hand and elbow surgeons, neurosurgeons, neurologists, and physical medicine and rehabilitation specialists.