Lecture by Dr. Somsak Leechavengvongs

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