Case Report: Double Oberlin Nerve Transfer to Restore Elbow Flexion Following C5-C6 Avulsion Injury

Oper Neurosurg (Hagerstown). 2019 Jan 1;16(1):23-26. doi: 10.1093/ons/opy064.

Abstract

Background and importance: The use of nerve transfers to restore nerve function following traumatic avulsion injuries has been described, though there is still a paucity in the literature documenting technique and long-term outcomes for these procedures. The double Oberlin nerve transfer involves transferring fascicles from the median and ulnar nerves to the musculocutaneous nerve to restore elbow flexion in patients with a C5-C6 avulsion injury. The purpose of this case report is to present our indications and technique for a double Oberlin transfer in addition to exhibiting video footage at follow-up time points documenting the incremental improvement in elbow flexion following the injury.

Clinical presentation: The patient is a 25-yr old, left-hand dominant male who presented 5 mo following a motor vehicle accident. He had 0/5 biceps muscle strength on the left with a computed tomography myelogram that demonstrated pseudomeningoceles from C2-C3 to C7-T1 with root avulsions of C5 and C6. He was subsequently indicated for a double Oberlin nerve transfer to restore elbow flexion.

Conclusion: In this case report, we present our technique and outcomes for a double Oberlin transfer with restoration of elbow flexion at 1-yr follow-up for a patient with traumatic brachial plexus injury. We believe that the double Oberlin transfer serves as a safe and effective method to restore elbow flexion in this patient population.

Publication types

  • Case Reports

MeSH terms

  • Accidents, Traffic
  • Adult
  • Elbow Joint / innervation*
  • Elbow Joint / physiopathology
  • Elbow Joint / surgery
  • Humans
  • Male
  • Median Nerve / transplantation*
  • Muscle Strength / physiology*
  • Nerve Transfer / methods*
  • Radiculopathy / diagnostic imaging
  • Radiculopathy / physiopathology
  • Radiculopathy / surgery*
  • Range of Motion, Articular / physiology*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ulnar Nerve / transplantation*