Brachial plexus nerve transfer reconstruction


HULC Peripheral Nerve Surgery Program

A full spectrum of adult and children’s complex peripheral nerve surgery, including brachial plexus surgery, is offered at the Hand and Upper Limb Centre.  Patients are assessed and treated by a comprehensive, multidisciplinary team that includes Physiotherapist, Specialists in Physical Medicine and Rehabilitation, Reconstructive Orthopaedic Surgeons and Peripheral Nerve Surgeons from
St. Joseph’s Health Centre and London Health Sciences Centre. 

Drs. Ross (Surgery) and Miller (Physical Medicine & Rehabilitation) run a Peripheral Nerve Specialty Clinic on a monthly basis for patients with complex peripheral nerve problems.  Patients are assessed clinically, electrodiagnostic testing is completed and a comprehensive treatment plan instituted.  This includes the pharmacologic management of neuropathic pain.

Surgical management includes decompression for compression neuropathies including carpal tunnel syndrome, cubital tunnel syndrome and thoracic outlet syndrome.  There is also specific expertise in acute nerve injuries including nerve injuries arising from trauma or tumor. All types of reconstructive nerve surgery are utilized including direct microscopic repair, nerve grafting, end-to-side nerve repair, reconstruction with nerve conduits, and nerve transfers.  Reconstruction for late or irreparable  nerve injuries is offered using tendon transfer surgery. The clinical picture above depicts a microscopic double nerve transfer of fascicles from the ulnar and median nerves transferred to the musculocutaneous nerve to restrore elbow flexion.

Peripheral nerve surgery is a complex and exciting field of surgery with new developments occurring on an almost monthly basis.  At the Hand and Upper Limb Centre, patients are offered state of the art care on a timely basis. 

For more information, patients may visit the website of the United Brachial Plexus Network.  This is a non-profit organization which provides information for adults with brachial plexus injuries or parents of children with obstetrical brachial plexus injuries.

The surgeon at HULC with a primary interest in brachial plexus surgery is
Dr. Douglas Ross. In addition, Dr. Chris Scilley in the UWO Division of Plastic Surgery and working out of LHSC also has a specific interest in brachial plexus surgery. Although all HULC surgeons perform certain peripheral nerve procedures, those with a more specific interest in peripheral nerve surgery are Dr. Ross, Dr. Temple, Dr. Richards, and Dr. Gan.