The brachial plexus is the network of nerves that sends signals from your spinal cord to your shoulder, arm and hand. These nerves control and administer feelings in the muscles of the shoulder, elbow, wrist, hand, and arm. This damage is also known as brachial plexopathy. A brachial plexus injury occurs when these nerves are stretched, compressed, or in the most serious cases, ripped apart or torn away from the spinal cord.

Nerve transfer is a surgical option that intentionally divides a physiologically active nerve (with low donor morbidity) and transfers it to a distal more important but irreparable paralytic nerve. The procedure is best done within a golden time period (within 5 months of the injury) to reactivate the paralyzed muscle early, effectively, and successfully.

Nerve transfer can be broadly classified into three categories:

• Extraplexus
• Intraplexus
• Close-target nerve transfers