The Rise of Nerve Transfers: Tracing a National Evolution Toward the Postgrafting Era in Brachial Plexus…

Cohort studyAnnals of plastic surgery· Jul 2026

The Rise of Nerve Transfers: Tracing a National Evolution Toward the Postgrafting Era in Brachial Plexus Injury Management.

Pooja Dhupati, Jonathan Jeger, Sunny Vansdadia … Shelley S Noland

Peripheral NerveCohort studyClinical practiceQ2IF 1.5

Nerve transfers were associated with lower 30-day complication rates than traditional reconstruction.

The Rise of Nerve Transfers: Tracing a National Evolution Toward the Postgrafting Era in Brachial Plexus Injury Management.

Pooja Dhupati … Shelley S Noland

Annals of plastic surgery · Jul 2026 · Q2 in Surgery

Background

Nerve transfers have been heralded as a "quantum leap" in peripheral nerve surgery, fundamentally altering the reconstructive paradigm over the past 2 decades.

Methods

Data were extracted from the National Surgical Quality Improvement Program (2006 to 2022).

n = 544 BPI patients

Results

fewer complications with nerve transfers despite treating higher-risk patients

Nerve transfer

2.5%

Traditional reconstruc

11%

More results

Among 544 brachial plexus injury patients, 80 underwent reconstruction involving a nerve transfer.

Plastic surgeons performed 60% of nerve transfers despite accounting for only 33.5% of all brachial plexus injury reconstructions.

More results

Neurosurgeons had the lowest overall nerve transfer utilization but increased to a rate matching orthopedic surgeons in the final 4 years.

In multivariable analysis, orthopedic and neurosurgeons remained significantly less likely than plastic surgeons to perform nerve transfers (OR: 0.26, P<0.001; OR: 0.18, P<0.001, respectively).

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Conclusion · 1 of 2

Nerve transfer use in brachial plexus injury reconstruction has increased steadily, with a recent increase among neurosurgeons.

Conclusion · 2 of 2

Despite being used in higher-risk patients, nerve transfers were associated with significantly lower short-term complication rates. These findings support continued adoption of nerve transfers and highlight their favorable safety profile.

The Rise of Nerve Transfers: Tracing a National Evolution Toward the Postgrafting Era in Brachial Plexus Injury Management.

The Rise of Nerve Transfers: Tracing a National Evolution Toward the Postgrafting Era in Brachial Plexus Injury Management.

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