A patient with isolated C5-C6 brachial plexus palsy has a normally functioning hand. Which transfer restores elbow flexion while preserving intrinsic hand function?
- A Intercostal nerves T3-T5 to musculocutaneous nerve
- B One or two fascicles of the ulnar nerve to the motor branch of the musculocutaneous nerve to biceps ✓
- C Contralateral C7 root to the median nerve
- D Hypoglossal nerve to the musculocutaneous nerve
Correct answer: B. One or two fascicles of the ulnar nerve to the motor branch of the musculocutaneous nerve to biceps
Explanation
The Oberlin transfer takes one or two fascicles of the ulnar nerve and coapts them directly to the biceps branch of the musculocutaneous nerve. It gives rapid, reliable elbow flexion with minimal donor deficit because only a small portion of ulnar fibres is sacrificed in a hand that is otherwise normal. Intercostal transfers are reserved for panplexus or preganglionic injuries where intraplexal donors such as ulnar fascicles are unavailable.
Reference: Campbell's Operative Orthopaedics, 14th ed.
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Written and medically reviewed by the StethoPrep medical team.