SynthesisActa neurochirurgica2025
Nerve transfer to musculocutaneous for elbow flexion restoration in brachial plexus injury (Ulnar and/or Median vs. Intercostal): A systematic review and meta-analysis of comparative studies.
Synthesis in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Motor Nerve Transfers in Complete and Incomplete Brachial Plexus Injuries: A State-of-the-Art Review.Neurology international · 2026Review
- Technical progress and clinical application of distal nerve transfers.Frontiers in surgery · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNerve transfers are a cornerstone in the surgical management of traumatic brachial plexus injuries (BPIs) to restore elbow flexion. Common donor nerves include intraplexal sources like the ulnar and median nerves (fascicular transfers) and extraplexal sources like the intercostal nerves (ICNs). Despite the widespread use of both techniques, the optimal donor nerve remains a subject of debate. This systematic review and meta-analysis aims to compare these techniques for restoring elbow flexion in BPIs.
methodsA systematic search was conducted across PubMed, Embase, Cochrane Library, Scopus, and Web of Science to identify comparative studies. The quality of the studies included was assessed using the Newcastle-Ottawa Scale (NOS). Meta-analyses were performed to compare motor recovery (≥ M3), time to M3 recovery, and complication rates between the two surgical approaches.
resultsThe analysis included 13 studies with a total of 537 patients. In the overall cohort, which included mixed injury patterns, fascicular transfers showed a statistically significant advantage for achieving ≥ M3 recovery (RR = 0.84, 95% CI [0.75, 0.94]). However, when the analysis was restricted to patients with only upper-BPIs, there was no significant difference in achieving ≥ M3 strength between fascicular and ICN transfers (RR = 0.92, 95% CI [0.82, 1.04]). Fascicular transfers resulted in a significantly faster time to ≥ M3 recovery by approximately five months (MD = 5.25, 95% CI [2.87, 7.62]). Donor-site morbidity (18 sensory, 10 motor deficits) and wrist co-flexion were reported in fascicular transfer groups, whereas pneumothorax (4 cases) was the primary complication for ICN transfers.
conclusionIn patients with upper-BPIs, fascicular and ICN transfers yield comparable elbow flexion strength. The choice of procedure is a trade-off between the faster recovery offered by fascicular transfers and the better rehabilitation course of ICN transfers.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.