Oberlin transfer

Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: anatomical study and report of four cases

Oberlin C, Béal D, Leechavengvongs S, et al. The Journal of hand surgery 1994 · PMID 8201186 · doi:10.1016/0363-5023(94)90011-6

Question

Can a fascicle of the ulnar nerve be transferred to the biceps motor branch to restore elbow flexion after upper brachial plexus avulsion?

Design

Cadaveric anatomical study plus a small clinical case series of four patients.

Patients

Patients with C5-C6 root avulsion of the brachial plexus.

Intervention

Transfer of part of the ulnar nerve (a fascicle) to the motor branch of biceps

Comparison

None

Primary outcome

Return of elbow flexion power (MRC grade)

Key result

Useful elbow flexion was restored in the reported cases without significant loss of ulnar nerve function in the hand.

Limitations

Very small uncontrolled series with short follow-up.

Impact on practice

Established distal nerve transfers close to the target muscle as a mainstay of brachial plexus reconstruction; the 'Oberlin transfer' is now standard for restoring elbow flexion in upper trunk injuries.