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Nerve Transfer Surgery: When and Why You Might Need It

If you were to take all the nerves in your body’s nervous system, stretch them out and place them end to end, they’d be more than 40 miles long. That’s a lot of delicate wiring!

Yes, nerve issues can be common —everything from carpal tunnel syndrome to peripheral neuropathy —  but the human nervous system is complex, and problems can show up in any number of ways. Nerve transfer surgery is an effective, increasingly popular solution.

We spoke with Joshua Hustedt, MD, an orthopedic and hand surgeon at Banner - University Orthopedic and Sports Medicine Institute in Phoenix, AZ, about nerve transfers. He explained the best reasons to get nerve transfer surgery, how the surgery works and its success rate.

Who should get nerve transfer surgery?

When someone suffers from pain, numbness, muscle weakness or limited mobility due to nerve dysfunction or nerve damage, nerve transfer surgery may be a good option. Some common reasons for nerve pain and nerve damage include:

  • Alcohol abuse
  • Amputations
  • Autoimmune disease (multiple sclerosis, Guillain-Barré syndrome, lupus, inflammatory bowel disease)
  • Cancer
  • Compression or trauma (pinched nerves, carpal tunnel syndrome, physical injury)
  • Diabetes
  • Drug side effects (cancer and HIV treatments)
  • Infectious disease (Lyme disease, herpes, HIV, hepatitis C)
  • Motor neuron diseases (ALS)
  • Nutrient deficiency (from excessive alcohol consumption or gastric surgery)

Dr. Hustedt noted that the two most common areas needing nerve transfer surgery are  the large upper and lower extremity nerves. The upper extremity nerves, for example, are often transferred to restore elbow, hand and finger function.

How does nerve transfer work?

When someone gets nerve transfer surgery, healthy nerves that are close to the affected nerve are transferred to the injured nerve. Dr. Hustedt compared it to the way an electrical wire might be spliced.

“If a wire does not have electricity, a neighboring wire with electricity can be split in half, and half can be connected to the non-live wire,” he said. “The same thing can be done with nerves. Over time the brain will rewire to allow for the function of both nerves.”

For example, if a damaged elbow receives a nerve transfer from a nerve that was previously dedicated for breathing, then the patient might need to take a deep breath at first to move their elbow. Gradually, though, the brain gets the hang of things, and the patient can move the elbow just fine without any extra breathing.

A nerve transfer isn’t the same thing as a nerve graft — the latter is used to repair a cut nerve. If a nerve graft isn’t successful, a nerve transfer can help restore function.

How successful is nerve transfer surgery?

Dr. Hustedt said every nerve injury is slightly different but assured that nerve transfer surgery has a high success rate. Nearly all nerve transfers, he explained, restore function to some degree. And in a lot of instances, full function is restored by very minimal surgical work. And better yet: you won’t need a cast after getting the surgery.

Mistakenly, people often think surgeons are “taking” from the nerve donor here — that to strengthen one area, another area needs to be weakened. This isn’t the case.

“All of our nerves have more than enough nerve tissue to allow us to donate to surrounding nerves without losing any function,” Dr. Hustedt explained. Most of the time, the donor nerve operates at full strength and the recipient nerve returns to nearly full strength.

What should I do next?

If you’re experiencing decreased nerve function, schedule an appointment with your medical provider to see if nerve transfer surgery might be a good next step. For a provider near you, visit to bannerhealth.com

If you’d like to learn more about neurological issues, read these articles written with help from Banner Health experts.

Neurosciences Orthopedics Pain Management