Oberlin Transfer
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This document discusses two Oberlin nerve transfer techniques for restoring elbow flexion after brachial plexus injury: 1. Oberlin I involves transferring a fascicle of the ulnar nerve to the motor branch of the biceps muscle. Over 100 patients who underwent this procedure regained M3 or greater elbow flexion strength, with recovery occurring between 5-11 months. 2. Oberlin II adds transferring a fascicle of the median nerve to the motor branch of the brachialis muscle. This "dual nerve transfer" technique was illustrated in a patient who showed recovery of both the biceps and brachialis muscles 10 months post-operatively. The Oberlin techniques rely on the proximity
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Oberlin Transfer
- 1. Oberlin Nerve Transfer for Elbow flexion in Brachial Plexus Injury Somsak Leechavengvongs, M.D. Institute of Orthopedics, Lerdsin Hospital Bangkok Thailand
- 2. Oberlin Procedure • Oberlin 1(1994) - 1 part of ulnar nerve to biceps branch • Oberlin 2 (2006) - 1 part of ulnar nerve to biceps branch - 1 part of median nerve to brachialis branch
- 3. Prof. Christophe Oberlin
- 5. J Hand Surg 1994;19A:232-237 Prof. C. Oberlin Bichat Hospital Paris Restoration of Elbow Flexion
- 6. Transfer of one fascicle of the ulnar nerve to branch to Biceps
- 7. J Hand Surg 1998;23A:250-255 The 1st br. always supply the short head The 2nd br. is 5-53 mm (avg, 22 mm) distal to the 1st br.
- 8. J Hand Surg 1998;23A:711-716 Ulnar nerve Nerve to biceps an ulnar n. fascicle the anastomosis ‘ Oberlin I ’ Biceps Brachialis
- 9. 93% (30/32 Pts) obtained > or = M3 No loss of ulnar nerve function noted J Hand Surg 1998;23A:711-716
- 10. The ulnar nerve is closer The rate of recovery is faster No nerve graft required Technically uncomplicated No special re-education required Reserving the other donor nerves J Hand Surg 1998;23A:711-716
- 11. A part of ulnar nerve transfer to motor branch to the biceps • From September 1992 – February 2006 • 192 cases with 112 cases more than 2 year’s follow – up evaluation • 93% regained >or = M3 (C5 and C6 ) • 58% regained >or = M3 (C5,C6 and C7) • Recovery of M3 occurred between 5 and 11 months after surgery (mean, 7 mo)
- 12. A part of ulnar nerve transfer to motor branch to the biceps • The elbow flexion power ranged from 0.5 to 7 kg (average = 2.6 kg) • No loss of ulnar nerve was noted after surgery • 28% experienced transient paresthesia in the small finger
- 13. Ulnar nerve Median nerve Nerve to biceps Nerve to brachialis Dual Nerve Transfer for Biceps & Brachialis Ulnar n. Median n. ‘Oberlin II’
- 14. 10 months after double nerve transfer to biceps and brachialis using fascicle of ulnar and median nerve