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.

Patients who delay that first visit to the doctor for more than 12 months after injury tend to have poor outcomes with surgery to reconstruct nerves. These patients are managed better with surgery that focuses on reconstructing the tendon (tendon transfer) or muscle (free-functioning muscle transfer).

A tendon transfer is a type of surgery in which the tendon of a functioning muscle is cut and sewn into a nonfunctioning muscle tendon to restore a specific motion or motor function.

In a free-functioning muscle transfer, a muscle from one part of the body is moved to the injured area, along with its tendon, artery, vein, and nerve. Each of these structures is connected to the corresponding structures of the injured area in order to restore motion or motor function.