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The Peripheral Nerve Surgery Program specializes in evaluating, diagnosing and treating patients with peripheral nerve disorders, including peripheral neuropathy, compression neuropathies such as carpal tunnel syndrome, peripheral nerve injuries, painful nerves (neuromas) and nerve tumors.
The Peripheral Nerve Surgery Service at Massachusetts General Hospital treats peripheral nerve injuries, tumors and other disorders affecting the network of nerves that link the brain and spinal cord to other parts of the body.
A nerve transfer is a surgical procedure that can be used to restore movement and feeling in limbs. It is commonly used when a patient has a nerve injury that causes a complete loss of movement or sensation. Nerve transfers involve taking nerves with less important roles and transferring them to restore function in nerve that has been severely damaged or injured.
Physicians at the Mass General Paralysis Center start by identifying functioning nerves that are close to the injured muscle or area of numbness. Providing a nearby source of nerve allows for faster recovery. The healthy nerve is then connected to the non-functioning nerve to restore its function. Once the nerves have been transferred, time is given for the nerves to grow to their new target. Once that target begins to demonstrate movement, the patient may have to learn how to activate that newly recovered movement. For example, if a nerve that previously participated in closing the hand is transferred to the elbow, the patient may initially have to make a fist in order to flex the elbow. With physical therapy, the patient learns this behavior and is eventually able to flex the elbow more automatically without using the maneuver.
Motor nerves are used to restore function to muscles, and sensory nerves are used to restore sensation.
The ulnar nerve is an example of an injured nerve that may be treated through this technique. This nerve travels down the arm and controls movement of the small muscles of the hand as well as sensation in a portion of the hand. A surgeon may use a motor branch of the median nerve to restore muscle function. To restore feeling, the surgeon will likely transfer sensory branch of the same nerve.
Benefits of a nerve transfer include:
- It restores the function of the original muscle without altering the anatomy of a patient’s arm
- Casting and immobilization is typically not required
- It gives a reconstructive option when tendon transfer is not available
- Sacrificing a simple function in a healthy area can potentially restore multiple functions to a paralyzed limb
The Mass General Paralysis Center is a multidisciplinary center featuring physicians and surgeons from a variety of service lines including Neurosurgery, Neurology, Radiology, Orthopaedics, Plastic Surgery and more. Our doctors work together to determine a treatment option that can address each patient’s unique situation. The Paralysis Center opened in 2018 and is led by Justin Brown, MD.
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